The Edmonton Obesity Staging System as a predictor for postoperative complications after medial thigh lift in massive weight loss patients

xlomafota13 shared this article with you from Inoreader The Edmonton Obesity Staging System as a predictor for postoperative complications after medial thigh lift in massive weight loss patients Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 20:S1748-6815(21)00197-2. doi: 10.1016/j.bjps.2021.03.093. Online ahead of print. ABSTRACT BACKGROUND: This study investigates the correlation between the Edmonton Obesity Staging System (EOSS) and the occurrence of postoperative complications after medial thigh lift in formerly obese patients. PATIENTS AND METHODS: A single-institution retrospective review of patients undergoing medial thigh lift between 2009 and 2019 after massive weight loss. Data on demography, comorbidities, surgery, and postoperative outcome were extracted from patients' charts. Patients were grouped into EOSS categories. Complications were classified into minor and major. Logistic regression analysis was performed to determine the association between risk factors and complications. RESULTS: One hundred and eight patients were included in the study. Complications occurred in 76 (70%) of the patients, most of whi ch were minor (60/108, 56%). Complications increased with increasing EOSS stage, and all EOSS 3 patients had complications. Classification as EOSS 2 or 3 significantly associated with occurrence of postoperative complications (OR 99.3, p<0.001) as well as minor and major complications individually (OR 3.1 and 6.5, p<0.05). This effect was independent of body mass index (BMI), maximum BMI loss, type of weight loss, volume of liposuction, weight of resected tissue, and type of surgery. CONCLUSION: EOSS is a robust and independent predictor for postoperative complications in medial thigh lift surgery after massive weight loss. PMID:34045144 | DOI:10.1016/j.bjps.2021.03.093 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Unilateral Choanal Atresia Presenting With Congenital Respiratory Distress and Recurrent Cyanotic Episodes

xlomafota13 shared this article with you from Inoreader Unilateral Choanal Atresia Presenting With Congenital Respiratory Distress and Recurrent Cyanotic Episodes Via ear nose throat Ear Nose Throat J. 2021 May 28:1455613211020978. doi: 10.1177/01455613211020978. Online ahead of print. ABSTRACT Congenital unilateral choanal atresia (CA) is not considered an emergent condition and should not cause respiratory distress in the newborn. Therefore, surgical repair of unilateral CA is usually delayed. This description of a newborn with congenital unilateral CA that caused significant respiratory distress, recurrent cyanotic episodes, and severe feeding difficu lties highlights an exception to that rule. PMID:34047200 | DOI:10.1177/01455613211020978 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Robotic Surgery can be Safely Performed for Patients and Healthcare Workers During COVID‐19 Pandemic

xlomafota13 shared this article with you from Inoreader Robotic Surgery can be Safely Performed for Patients and Healthcare Workers During COVID‐19 Pandemic Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Objectives To investigate the safety of robotic surgery during COVID-19 pandemic concerning new-acquired COVID-19 infections for patients and healthcare workers. Patients We performed a retrospective single-centre cohort study of patients undergoing robotic surgery in initial period of COVID-19 pandemic. Patients and Healthcare workers COVID-19 infection status was assessed by structured telephone follow-up and/or repeated nasopharyngeal swabs. Results After 61 robotic surgeries (93,5% cancer surgery), 1 patient (1.6%) had COVID-19 infection. 60 healthcare workers cumulatively exposed to 1,187 hours of robotic surgery had no infection. One patient with postoperative proof of SARS-CoV-2 had complete recovery. After this potentially contagious robotic surgery, 8 healthcare workers had no COVID-19 infection after follow-up with each 3 nasopharyngeal swabs. Conclusions Early clinical experience of robotic surgery during COVID-19 pandemic shows that robotic surgery can be safely performed for patients and healthcare workers. Despite our results we recommend elective surgery only for verified COVID-19 negative patients. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Local immune microenvironment of skin may play an important role in the development of pretibial myxedema

xlomafota13 shared this article with you from Inoreader Local immune microenvironment of skin may play an important role in the development of pretibial myxedema Via Experimental Dermatology Abstract Pretibial myxedema (PTM), characterized by the accumulation of glycosaminoglycans in dermis is an autoimmune skin disorder, which is almost always associated with Graves' disease (GD). Although fibroblast stimulated by thyroid-stimulating hormone receptor (TSHR) antibody, cytokines and growth factors has been postulated as target of the autoimmune process in the dermopathy, the pathogenesis of PTM remains unclear. We hypothesise that the local immune microenvironment of the skin including the antigens and antibodies, T cells, B cells, plasma cells and fibroblasts may play an important role in the development of PTM. Results obtained on PTM patients indicate increased thyroid-stimulating hormone receptor antibodies (TRAb) in the blood positively correlate with the dermal thickness of the lesions. Further analysis show that there were more CD3+ T cells and CD20+ B cells in the skin lesions. These T and B cells are in close contact, indicating that inducible skin-associated lymphoid tissue (iSALT) may be formed in the area. In addition, we found that the infiltrating plasma cells can secrete TRAb, proving that B cells in the skin other than the thyroid are an additional source of TSHR antibodies. Meanwhile, the T and B cells in the skin or skin homogenate of patients can promote the proliferation of pretibial fibroblasts. In conclusion, our results provide evidence that the local immune microenvironment of the skin may play an important role in the development of PTM. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Dexmedetomidine reduces the apoptosis of rat hippocampal neurons via mediating ERK1/2 signal pathway by targeting miR-155

xlomafota13 shared this article with you from Inoreader Dexmedetomidine reduces the apoptosis of rat hippocampal neurons via mediating ERK1/2 signal pathway by targeting miR-155 Via histochem Acta Histochem. 2021 May 25;123(5):151734. doi: 10.1016/j.acthis.2021.151734. Online ahead of print. ABSTRACT Rat hippocampal neurons were isolated and divided into Normal, oxygen glucose deprivation/reoxygenation (OGD/R), OGD/R + DEX, OGD/R + NC mimic, OGD/R + miR-155 mimic and OGD/R + DEX + miR-155 mimic groups. In OGD/R group, LDH, ROS and MDA levels and apoptosis rate was increased, with up-regulations of miR-155, Cyt c and Bax/Bcl-2 ratio, but decreases of SOD, GSH-Px a nd MMP levels, as well as down-regulations of p-ERK1/2/ERK1/2. As compared to the OGD/R group, parameters above in the OGD/R + DEX group were ameliorated evidently, while OGD/R + miR-155 mimic group manifested the opposite changes. Besides, miR-155 mimic could abolish the protective effect of DEX on the hippocampal neurons under OGD/R. DEX, via down-regulating the expression of miR-155, could activate the ERK1/2 pathway, thereby mitigating the apoptosis and oxidative stress injury and increasing the MMP, thereby protecting hippocampal cells from OGD/R injury. PMID:34048989 | DOI:10.1016/j .acthis.2021.151734 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Propofol suppressed cell proliferation and enhanced apoptosis of bladder cancer cells by regulating the miR-340/CDK2 signal axis

xlomafota13 shared this article with you from Inoreader Propofol suppressed cell proliferation and enhanced apoptosis of bladder cancer cells by regulating the miR-340/CDK2 signal axis Via histochem Acta Histochem. 2021 May 25;123(5):151728. doi: 10.1016/j.acthis.2021.151728. Online ahead of print. ABSTRACT BACKGROUND: As widely reported, propofol can effectively inhibit tumors development. However, little is known about the molecular mechanisms. Here, we proved that propofol regulated miR-340/CDK2 axis to suppress bladder cancer progression in vitro. METHODS: MicroRNA (MiR)-340 expression in 5637 cells was examined using qRT-PCR. Cyclin-dependent kinase2 (CDK2) ex pression was detected using both qRT-PCR and western blot. The levels of apoptosis-related proteins and cell cycle-related proteins were evaluated using western blot. CCK-8 assay and BrdU assay were conducted to evaluate cell proliferation. Moreover, flow cytometry assay was employed to assess cell cycle and cell apoptosis. Finally, dual luciferase reporter assay was employed to verify the binding relationship between miR-340 and CDK2. RESULTS: Here we showed that propofol treatment inhibited cell proliferation of 5637 cells but enhanced cell apoptosis. Propofol upregulated miR-340 in a dose and time dependent manner. MiR-340 inhibitor could reverse the effect of propofol on the proliferation and apoptosis of 5637 cells. Next, dual luciferase reporter assay displayed that miR-340 directly bound to the 3'-UTR of CDK2. Finally, inhibition of CDK2 could partly reversed the effect of miR-340 inhibitor on cell proliferation and cell apoptosis of propofol-treated 5637 cells. C ONCLUSION: In total, our results proved that targeting miR340/CDK2 axis was novel to enhance the anti-tumor effects of propofol in bladder cancer in vitro, and our study provided alternative therapeutic strategies for clinical treatment of bladder cancer. PMID:34048990 | DOI:10.1016/j.acthis.2021.151728 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Constructing Stable and Porous Covalent Organic Frameworks for Efficient Iodine Vapor Capture

xlomafota13 shared this article with you from Inoreader Constructing Stable and Porous Covalent Organic Frameworks for Efficient Iodine Vapor Capture Via radioactive iodine Macromol Rapid Commun. 2021 May 29:e2100032. doi: 10.1002/marc.202100032. Online ahead of print. ABSTRACT Covalent organic frameworks (COF) with periodic porous structures and tunable functionalities are a new class of crystalline polymers connected via strong covalent bonds. Constructing COF materials with high stability and porosity is attracting and essential for COFs' further functional exploration. In this work, two new covalent organic frameworks (TTA-TMTA-COF and TTA-FMTA-CO F) with high surface area, large pore volume, and excellent chemical stability toward harsh conditions are designed and synthesized by integrating the methoxy functional groups into the networks. Both two COFs are further employed for iodine removal since radioactive iodine in nuclear waste has seriously threatened the natural environment and human health. TTA-TMTA-COF and TTA-FMTA-COF can capture 3.21 and 5.07 g g-1 iodine, respectively. Notably, the iodine capture capacity for iodine of TTA-FMTA-COF does not show any decline after being recycled five times. These results demonstrate both COFs possess ultrahigh capacity and excellent recyclability. PMID:34050692 | DOI:10.1002/marc.202100032 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Place of coordination of complex pathways in oncology by coordinating privates nurses

xlomafota13 shared this article with you from Inoreader Place of coordination of complex pathways in oncology by coordinating privates nurses Via Association française pour l'étude du cancer Bull Cancer. 2021 May 25:S0007-4551(21)00182-X. doi: 10.1016/j.bulcan.2021.03.016. Online ahead of print. ABSTRACT BACKGROUND: The complexity of the hospital-city care pathway is a real challenge because of the lack of coordination and communication between many stakeholders. As part of a call for projects from the General Directorate of Healthcare Provision, an experiment involving private oncology coordinating nurses was developed to address this issue. To our knowledge, there is no evaluation so far of such a protocol . METHODS: This single-center retrospective study focused on data from the ONC'IDEC program between 2015 and 2018, where 28 private nurses provided a 24/7 hotline. The objective was to qualitatively assess the coordination of this system. The nature and number of calls, patient satisfaction and medico-economic parameters were assessed. RESULTS: More than a hundred patients (n=114) were included in this devi ce (mean age: 72 ± 12 years). The most frequent reasons for calls concerned the patient's general condition (35 %) and home treatment follow-ups (13 %) but also referrals to the primary doctor (4 %), which helped avoiding hospitalizations. The patients were satisfied with the experiment (overall score of 8.4/10). DISCUSSION: Thanks to the ONC'IDEC program, patients were able to benefit from more appropriate care through a privileged interlocutor by making their care pathway more fluid and avoiding hospitalizations. It would be interesting to confirm these results by means of a study with a higher level of evidence, by comparing this protocol to conventional hospital coordination. PMID:34049669 | DOI:10.1016/j.bulcan.2021.03.016 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A 45-degree Upward Tension-Releasing Epicanthoplasty Performed in 712 Consecutive Cases

xlomafota13 shared this article with you from Inoreader A 45-degree Upward Tension-Releasing Epicanthoplasty Performed in 712 Consecutive Cases Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 20:S1748-6815(21)00220-5. doi: 10.1016/j.bjps.2021.03.116. Online ahead of print. ABSTRACT BACKGROUND: Medial epicanthoplasty is commonly used to enhance the aesthetic outcomes of double-eyelid operations in Asia. However, epicanthoplasty can cause problems such as scarring and excessive exposure of the lacrimal lakes. OBJECTIVES: To resolve the problems associated with epicanthoplasty and to create more natural and long-lasting double-eyelid fold lines while minimizing incisions, we performed a 45-degree upward tension-releasing epicanthoplasty. MATERIALS AND METHODS: A total of 712 patients underwent 45-degree upward tension-releasing epicanthoplasty, with or without double eyelidplasty. A triangular skin flap was elevated at a 45-degree angle from the epicanthal fold. The surrounding area was dissected to eliminate the rigid connective tissue between the orbicularis muscle and the skin, which creates skin tension. The incisions were sutured, and a small incision toward the medial canthus was added to further decrease tension and create space for the triangular flap to be transposed. RESULTS: A total of 707 patients underwent 45-degree upward tension-releasing epicanthoplasty with the double-eyelid procedure, and 5 patients underwent 45-degree upward tension-releasing epicanthoplasty alone. No complications were observed for any patients, and 95% of patients were satisfied with this technique. CONCLUSIONS: The 45-degree upward tension-releasing epicanthoplasty can release the tension in the epicanthal fold, minimize scarring, and control lacrimal lake exposure. In particular, this method was effective for creating an in-out double-fold line starting from the epicanthus and for maintaining the double-eyelid line, which can reduce unnecessary incisional double-eyelid surgery. PMID:34049838 | DOI:10.1016/j.bjps.2021.03.116 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Acute limb shortening or creation of an intentional deformity to aid in soft tissue closure for IIIB/IIIC open tibia fractures

xlomafota13 shared this article with you from Inoreader Acute limb shortening or creation of an intentional deformity to aid in soft tissue closure for IIIB/IIIC open tibia fractures Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 20:S1748-6815(21)00207-2. doi: 10.1016/j.bjps.2021.03.105. Online ahead of print. ABSTRACT BACKGROUND: Ring fixator techniques can precisely correct complex long bone deformities. In select patients, controlled shortening or intentional fracture deformation with delayed correction can also aid in complex wound coverage and limb salvage. METHODS: This retrospective cohort study analyzed all patients who underwent acute limb shortening or intentional temporary fracture deformation between 2005 and 2020. Patients were divided into three groups based on reason for acute shortening or intentional deformity: (1) skeletal indications alone, with traditional flap coverage; (2) skeletal and soft tissue indications, to augment traditional reconstructive measures; and (3) skeletal and soft tissue indications, to avoid microsurgery altogether. Comorbidities, orthopedic and reconstructive methods, and f unctional outcomes were recorded. RESULTS: Eighteen patients were identified: six in Group 1, five in Group 2, and seven in Group 3. Fractures were primarily in the distal third of the tibia. On initial assessment, all wounds would have required free tissue transfer. Group 1 patients were reconstructed with free flaps. Among Group 2, closure was accomplished by skin grafting (N = 1), local flaps (N = 1), pedicled muscle flaps (N = 1), and free flaps (N = 2). In Group 3, five wounds were closed primarily and two were skin grafted. All limbs were shortened, averaging 25.1 mm; seven were intentionally deformed, most commonly varus (10-20°). After skeletal correction, residual leg length discrepancy averaged 5.7 mm. No patients required amputation. CONCLUSIONS: Acute skeletal shortening with or without intentional temporary deformation in select IIIB/IIIC open tibial fractures can facilitate soft tissue coverage and limb salvage in patients who might otherwise require amput ation. PMID:34049839 | DOI:10.1016/j.bjps.2021.03.105 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Multi-Disciplinary Skull Base Conference and its Effects on Patient Management

xlomafota13 shared this article with you from Inoreader Multi-Disciplinary Skull Base Conference and its Effects on Patient Management Via otol rhinol Ann Otol Rhinol Laryngol. 2021 May 28:34894211021251. doi: 10.1177/00034894211021251. Online ahead of print. ABSTRACT OBJECTIVE: Examine the effects of a multi-disciplinary skull base conference (MDSBC) on the management of patients seen for skull base pathology in a neurotology clinic. METHODS: Retrospective case review of patients who were seen in a neurotology clinic at a tertiary academic medical center for pathology of the lateral skull base and were discussed at an MDSBC between July 2019 and February 2020. Patient characteristics, nature of the skull base pathology, and pre- and post-MDSBC plan of care was categorized. RESULTS: A total of 82 patients with pathology of the lateral skull base were discussed at a MDSBC during an 8-month study period. About 54 (65.9%) had a mass in the internal auditory canal and/or cerebellopontine angle while 28 (34.1%) had other pathology of the lateral skull base. Forty-nine (59.8%) were new patients and 33 (40.2%) were established. The management plan changed in 11 (13.4%, 7.4-22.6 95% CI) patients as a result of the skull base conference discussion. The planned management changed from some form of treatment to observation in 4 patients, and changed from observation to some form of treatment in 4 patients. For 3 patients who underwent surgery, the planned approach was altered. CONCLUSIONS: For a significant proportion of patients with pathology of the lateral skull base, the management plan ch anged as a result of discussion at an MDSBC. Although participants of a MDSBC would agree of its importance, it is unclear how an MDSBC affects patient outcomes. PMID:34049445 | DOI:10.1177/00034894211021251 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.