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Facial Plastic Surgery Clinics of North... Nov 2019The pinched nasal tip deformity often results as sequelae of prior nasal surgery. Conventional tip surgery techniques that overemphasize tip narrowing often deform the... (Review)
Review
The pinched nasal tip deformity often results as sequelae of prior nasal surgery. Conventional tip surgery techniques that overemphasize tip narrowing often deform the lateral crura and weaken support for the alar margin. The pinched nasal tip is characterized by the demarcation between the nasal tip and the alar lobule, isolating the tip from the surrounding nasal subunits. Lateral crural strut grafts with or without repositioning offer the surgeon a powerful maneuver that can help correct this functional and aesthetic deformity and restore a natural appearance to the nasal tip.
Topics: Humans; Hyaline Cartilage; Nose; Nose Deformities, Acquired; Preoperative Period; Rhinoplasty; Tissue and Organ Harvesting
PubMed: 31587767
DOI: 10.1016/j.fsc.2019.07.004 -
Aesthetic Surgery Journal. Open Forum 2022Textured breast implants have been used in aesthetic breast surgery to decrease rates of malposition and capsular contracture. Recent concerns regarding breast...
BACKGROUND
Textured breast implants have been used in aesthetic breast surgery to decrease rates of malposition and capsular contracture. Recent concerns regarding breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)'s link to textured devices have prompted many physicians to reevaluate their use.
OBJECTIVES
The authors aimed to create an algorithm for when to use smooth vs micro-textured breast implants and provide their rationale for when micro-textured implants may be more beneficial.
METHODS
In total, 133 patients received primary augmentations performed by a single surgeon from January 2018 to December 2020; 84 patients received smooth implants and 49 patients received micro-textured implants. All surgeries were performed in the dual plane using an inframammary incision. Implant-related complications and scar malposition were recorded and compared between groups.
RESULTS
No significant difference in the prevalence of implant-related complications was found (3.57% for smooth devices and 2.04% for micro-textured devices [-value 0.621257; 95% CI -0.06100 to 0.007467]). There were no cases of BIA-ALCL. A comparison of scar malposition rates between the smooth and micro-textured groups also revealed no statistically significant difference (15.4% for smooth devices and 8.16% for micro-textured devices [-value 0.226156; 95% CI -0.1200 to 0.007467]). Patients in the micro-textured group proportionately had more anatomical risk factors for malposition.
CONCLUSIONS
Micro-textured breast implants continue to be a safe and effective choice for patients. Micro-textured implants show a trend toward decreased scar malposition, although not statistically significant. Patients at high risk for malposition with micro-textured breast implants give similar results to patients at average risk for malposition with smooth implants.
PubMed: 35601234
DOI: 10.1093/asjof/ojac020 -
American Journal of Obstetrics &... Nov 2021Fetuses with malpresentation and malposition during labor represent important clinical challenges. Women with fetuses presenting with malpresentation or malposition are... (Review)
Review
Fetuses with malpresentation and malposition during labor represent important clinical challenges. Women with fetuses presenting with malpresentation or malposition are at risk of increased perinatal complications, such as cesarean delivery, failure of operative vaginal delivery, neonatal acidemia, and neonatal intensive care admission. Intrapartum ultrasound has been found to be more reliable than digital examination in assessing malpresentation and malposition. The use of intrapartum ultrasound to assess fetal position and presentation, in addition to fetal attitude, to predict and aid in decision making regarding delivery can help in improving management decision making. Cephalic malpresentation and malposition is a unique subset of fetal orientation and can benefit from intrapartum ultrasound identification and assessment for delivery.
Topics: Delivery, Obstetric; Female; Fetus; Humans; Infant, Newborn; Labor Presentation; Pregnancy; Ultrasonography; Ultrasonography, Prenatal
PubMed: 34302995
DOI: 10.1016/j.ajogmf.2021.100438 -
The Journal of Vascular Access May 2022Peripherally inserted central catheter (PICC) has been widely used. The catheter-related complications might occur and the reports of secondary malposition into azygos...
BACKGROUND
Peripherally inserted central catheter (PICC) has been widely used. The catheter-related complications might occur and the reports of secondary malposition into azygos veins were rare.
METHODS
This retrospective review summarized the experience in diagnosis and management of secondary malposition of PICC into azygos veins in 25 cases.
RESULTS
When the catheter dysfunction occurred in the PICC on the left limb, it was necessary to consider whether there would be malposition into azygos veins after other reasons were excluded. The malposition could be diagnosed by chest lateral radiograph or chest computed tomography. The secondary malposition into azygos veins was resolved by repositioning or withdrawing the PICC. After re-inserting the catheter, it should be closely monitored whether the malposition occurred again. Intracavitary electrocardiogram positioning technology was used to confirm the catheter tip position before using corrosive drug. After the catheters withdrawn from the azygos veins, close attention should be paid to the property and concentration of the infusion drug strictly and the complications such as blockage and re-malposition. No serious complications such as infection, thrombosis and extravasation occurred in this group of patients after treatment.
CONCLUSIONS
The results of our study suggested that the right limb is recommended for PICC catheterization in order to avoid secondary malposition into azygos veins and the malposition into azygos veins should be dealt with in time.
Topics: Azygos Vein; Catheterization, Central Venous; Catheterization, Peripheral; Central Venous Catheters; Humans; Tomography, X-Ray Computed
PubMed: 33719694
DOI: 10.1177/1129729821999484 -
Facial Plastic Surgery Clinics of North... Nov 2021Symmetric pocket formation and meticulous implant carving are the most critical parts of nasal dorsal augmentation using implants. Innovative three-dimensional printed... (Review)
Review
Symmetric pocket formation and meticulous implant carving are the most critical parts of nasal dorsal augmentation using implants. Innovative three-dimensional printed nasal implants can exactly fit the nasal dorsal contour, decreasing the chance of deviation and malpositioning. Vertically oriented folded dermal graft technique can avoid the high resorption rate of conventional dermofat grafts. Multilayered costal cartilage graft technique for dorsal augmentation can minimize warping and difficulty in the graft carving. Derotation graft allows supple and movable nasal tip while enabling enough tip lengthening, even if the septal extension graft is the most commonly performed procedure for short nose correction.
Topics: Asian People; Costal Cartilage; Humans; Nose; Reoperation; Rhinoplasty
PubMed: 34579840
DOI: 10.1016/j.fsc.2021.06.010 -
Abdominal Radiology (New York) Feb 2023The ileal loops are anatomical location for the majority of congenital anomalies affecting the gastrointestinal tract. These include Meckel's diverticulum, ileal... (Review)
Review
The ileal loops are anatomical location for the majority of congenital anomalies affecting the gastrointestinal tract. These include Meckel's diverticulum, ileal duplication, dysgenesis, atresia, mucosal diaphragm, and malposition of the ileum. Symptomatic lesions that often present with abdominal pain, intestinal obstruction or bleeding are usually diagnosed and treated during infancy and childhood. However, many of these congenital conditions may remain clinically silent and detected incidentally in adults undergoing radiological evaluation for unrelated medical reasons. This article presents the spectrum of the congenital ileal anomalies and their distinct features on small bowel examination and CT of the abdomen.
Topics: Humans; Adult; Child; Ileum; Diagnostic Imaging; Meckel Diverticulum; Intestinal Obstruction
PubMed: 36401130
DOI: 10.1007/s00261-022-03739-3 -
PloS One 2022Occiput-posterior (OP) or occiput-transverse (OT) fetal malposition has a prevalence of 33-58% in the first-stage of labour with 12-22% persisting until delivery....
INTRODUCTION
Occiput-posterior (OP) or occiput-transverse (OT) fetal malposition has a prevalence of 33-58% in the first-stage of labour with 12-22% persisting until delivery. Malposition is associated with significant maternal and neonatal morbidity. Most previous studies report the incidence and adverse maternal and fetal outcomes of persistent fetal malposition in the second stage of labour and do not include outcomes that may be present in the first stage of labour.
AIMS
To assess the incidence and health outcomes for women and their newborn infants of a fetal malposition in the first or second stage of labour.
MATERIALS AND METHODS
A retrospective cohort study of 738 maternity records (randomly selected) from a tertiary hospital in New Zealand. Maternal and neonatal characteristics are described. Outcomes for women with a fetus in an OP or OT position in labour are compared to those for women with a fetus in an occiput-anterior position (OA).
RESULTS
499 (68%) women had an OP/OT positioned fetus and 239 (32%) had an OA positioned fetus on vaginal examination in labour. Women had similar characteristics except a body mass index ≥30 kg/m2 was more common in the OP/OT group. Fetal malposition appears to be more likely in women with a right-sided fetal occiput. Three quarters of OP/OT fetuses rotated anteriorly by birth. Fetal malposition compared to no malposition was associated with oxytocin augmentation, epidural use, a longer first stage of labour, fewer normal vaginal births, and more caesarean sections. Fetal malposition during labour was not associated with adverse neonatal outcomes.
CONCLUSION
Interventions such as maternal posture in the first and second stage of labour could potentially reduce the incidence of malposition and improve health outcomes for mothers.
Topics: Infant, Newborn; Female; Pregnancy; Humans; Male; Oxytocin; Retrospective Studies; Labor Presentation; Cesarean Section; Outcome Assessment, Health Care
PubMed: 36260647
DOI: 10.1371/journal.pone.0276406 -
MMW Fortschritte Der Medizin Apr 2023
Topics: Humans; Family Practice; Foot
PubMed: 37016206
DOI: 10.1007/s15006-023-2411-4 -
The Journal of Maternal-fetal &... Dec 2022The fetal head malposition in labor leads to prolonged labor, cesarean delivery and increased perinatal morbidity. Epidural analgesia has been associated with fetal head...
BACKGROUND
The fetal head malposition in labor leads to prolonged labor, cesarean delivery and increased perinatal morbidity. Epidural analgesia has been associated with fetal head malposition, but it remains unknown if this relation is causal.
OBJECTIVE
To compare the incidence of fetal malposition during labor and maternal/fetal outcomes, between women who received epidural analgesia with those who did not use the analgesic method.
STUDY DESIGN
Case control study including 500 women with a single fetus in vertex position who gave birth at term at the Policlinic Hospital of Modena between May 2019 and July 2019. Two-hundred and fifty women belonged to the (EA) group and 250 to the group.
RESULTS
The rate of posterior occiput positions occurred 4 times more frequently in the EA group than in the control group (8.8% vs 2.2%, = .004). Cesarean sections were significantly higher in the EA group (11.6% vs 1.6%, < .0000) as well as the need for augmentation with oxytocin (20% vs 8%, = .0001) compared to the control group, in which spontaneous delivery prevailed instead. Women with epidural had labors that lasted on average 7.0 h against the 3.30 h of controls ( < .0000). The length of 2nd stage of labor was 55 vs 30 min ( = .009), respectively. No differences in blood loss and Apgar score between groups. Early breastfeeding was significantly higher among controls (82% vs 92.8%, = .0004).
CONCLUSIONS
Women receiving epidural analgesia in labor have higher rate of fetal malposition, prolonged labors, and more cesarean sections than controls. However, further studies are required to confirm a causal association between EA and fetal head malposition.
Topics: Pregnancy; Female; Humans; Analgesia, Epidural; Case-Control Studies; Labor Presentation; Labor, Obstetric; Cesarean Section; Fetus; Analgesia, Obstetrical
PubMed: 33615965
DOI: 10.1080/14767058.2021.1890018 -
Radiologic Clinics of North America Jan 2020Central venous catheters (CVCs) are commonly used in patients in a variety of clinical settings, including the intensive care unit, general ward, and outpatient... (Review)
Review
Central venous catheters (CVCs) are commonly used in patients in a variety of clinical settings, including the intensive care unit, general ward, and outpatient settings. After placement, the radiologist is frequently requested to evaluate the location of CVCs and deem them suitable for use. An understanding of the ideal location of catheter tips as well as the approach to identifying malpositioned catheter tips is essential to prevent improper use, recognize and/or prevent further injury, and direct potential lifesaving care. An approach to CVC placement based on tip location can be helpful in localization and guiding management.
Topics: Central Venous Catheters; Humans; Jugular Veins; Medical Errors; Radiography, Thoracic; Subclavian Vein; Tomography, X-Ray Computed
PubMed: 31731895
DOI: 10.1016/j.rcl.2019.08.011