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BMC Surgery Apr 2024The endoscopic thyroidectomy areola approach (ETAA) has been widely applied for papillary thyroid carcinoma (PTC), but leaves scars and is not truly minimally invasive.... (Comparative Study)
Comparative Study
BACKGROUND
The endoscopic thyroidectomy areola approach (ETAA) has been widely applied for papillary thyroid carcinoma (PTC), but leaves scars and is not truly minimally invasive. The oral vestibular approach (ETOVA) leaves no scars and is even more minimally invasive. However, there have been few comparative studies of ETAA and ETOVA for PTC. The purpose of our research was to compare two PTC treatment methods in terms of feasibility, safety, efficacy, and cosmetic results.
METHODS
A total of 129 patients with PTC underwent thyroidectomy combined with central lymph node dissection by the same surgeon. Among them, 79 patients underwent the ETOVA, and the others underwent the ETAA. We compared the two groups in terms of operative outcomes, postoperative complications, and cosmetic results.
RESULTS
No significant differences were found in the clinical characteristics between the ETOVA and ETAA groups. There were no significant differences in the number of removed lymph nodes (P = 0.279) or the number of positive lymph nodes (P = 0.569), but the ETOVA group had a higher number of removed lymph nodes. There was also no significant difference in blood loss volume(P = 0.180), postoperative drainage volume (P = 0.063), length of hospital stay (P = 0.182), transient RLN injury rate (P = 1.000), permanent RLN injury rate (P = 1.000), or recurrence rate (P = 1.000). The ETOVA was a longer operation than the ETAA was (P < 0.01). The ETOVA group had less pain (VAS 1: P < 0.01, VAS 3: P = 0.001), less neck discomfort (1 month after surgery: P = 0.009, 3 months after surgery: P = 0.033), and better cosmetic results (P = 0.001).
CONCLUSIONS
The ETOVA is not inferior to the ETAA in terms of safety and curability of PTC and is advantageous in terms of central lymph node dissection, minimal invasiveness, and cosmetic results.
TRIAL REGISTRATION
This study was approved by the Ethics Committee of Zhongshan Hospital of Xiamen University (2017 V1.0). No funding was received.
Topics: Humans; Thyroidectomy; Female; Male; Thyroid Neoplasms; Thyroid Cancer, Papillary; Middle Aged; Adult; Endoscopy; Treatment Outcome; Postoperative Complications; Retrospective Studies; Feasibility Studies; Lymph Node Excision
PubMed: 38678205
DOI: 10.1186/s12893-024-02413-3 -
Poultry Science Jun 2024Between 3 and 20 wk of age (WOA), the effects of water access time and access to alfalfa during the rearing phase on the litter conditions, performance, and behavior of...
Between 3 and 20 wk of age (WOA), the effects of water access time and access to alfalfa during the rearing phase on the litter conditions, performance, and behavior of broiler breeder pullets was studied. A total of 480 female one-day-old chicks (Ross 308) were randomly assigned to 24 floor pens (20 pullets/pen) within a 3 × 2 factorial completely randomized block design. Between 3 and 20 WOA, pullets received water 1) between 07:30 am and 10:30 pm h (3HR), 2) in 2 periods between 07:30 am and 11:00 pm h and between 14:00 pm and 15:30 pm h (5HR), or 3) during the entire light period (8HR). Half of the pens had unlimited access to alfalfa straw (ALF+) or not (ALF-). Higher water use and water-to-feed ratios were observed in the 5HR and 8HR pullets compared to the 3HR pullets (P < 0.001), with no effect observed from unlimited alfalfa. Clear differences in water use throughout the day were observed for the different water strategies. The dry matter (DM) content in the litter was lower, and the litter friability and moisture scores were higher in the 5HR and 8HR than the 3HR pens (P < 0.001), with no differences in fresh feces DM. Alfalfa straw had no effect on litter DM content, fresh feces DM content, litter friability score, or litter moisture score. Feather cover score and feather and footpad contamination score were higher in 5HR and 8HR pullets than in 3HR pullets (P < 0.05), with no differences between the ALF+ and ALF- pullets. The 5HR and 8HR pullets showed increased pecking at alfalfa straw and drinking nipples, along with decreased foraging and perching than the 3HR pullets (P < 0.05). Additionally, ALF+ pullets showed a tendency for less object pecking behavior (P = 0.066) than ALF- pullets. In conclusion, the study demonstrated that extended access to water in breeder pullets increased water use, resulting in inferior litter quality, decreased feather cover, and decreased feather cover and footpad contamination. Moreover, unlimited access to alfalfa straw decreased object pecking behavior.
Topics: Animals; Chickens; Medicago sativa; Female; Housing, Animal; Animal Husbandry; Floors and Floorcoverings; Water; Random Allocation; Time Factors; Behavior, Animal
PubMed: 38663205
DOI: 10.1016/j.psj.2024.103773 -
World Journal of Clinical Cases Apr 2024Jaffe-Campanacci syndrome (JCS) is a very rare syndrome. The treatment of JCS is more conservative, and most authors recommend that no surgery should be done in...
BACKGROUND
Jaffe-Campanacci syndrome (JCS) is a very rare syndrome. The treatment of JCS is more conservative, and most authors recommend that no surgery should be done in asymptomatic patients. The conventional concept holds that the natural course of non-ossifying fibromas (NOFs) grows with the development of bones, and the osteolytic region gradually stops expanding and self-healing through bone ossifying around the lesion and ossification within the lesion. But in this case, the bone lesions were potentially biologically aggressive, which led to severe limb deformities and pain.
CASE SUMMARY
We present the case of a 5-year-old girl with JCS presenting with not only NOF sand café-au-lait macules, but also showed features not mentioned before, severe limb pain, and at last resulted in amputation. She was admitted to our hospital after presenting with claudication and mild pain over her right thigh, which worsened when stretching or being touched. Skin examination revealed multiple café-au-lait macules on the neck, arm, axilla, and torso, including the nipples and perineum. Radiographs revealed multiple lytic lesions in the proximal part of the right humerus, distal part of the right clavicle, proximal and distal parts of the right femur, and proximal parts of the right tibia and fibula. Curettage and biopsy were performed on the distal part of the right femur. At the age of 7, the girl was re-admitted to our hospital for a pathological fracture in the middle in the right femur and underwent Intralesional excision, internal fixation, bone grafting, and spica casting. At the age of 10, the girl came to our hospital again for severe pain of the right leg. Amputation from the middle level of the right femur was performed. We present the case of a 5-year-old girl with JCS presenting with not only NOFs and café-au-lait macules, but also showed features not mentioned before, severe limb pain, and at last resulted in amputation. She was admitted to our hospital after presenting with claudication and mild pain over her right thigh, which worsened when stretching or being touched. Skin examination revealed multiple café-au-lait macules on the neck, arm, armpit, and torso, including the nipples and perineum. Radiographs revealed multiple lytic lesions in the proximal part of the right humerus, distal part of the right clavicle, proximal and distal parts of the right femur, and proximal parts of the right tibia and fibula. Curettage and biopsy were performed on the distal part of the right femur. At the age of 7, the girl was re-admitted to our hospital for a pathological fracture in the middle in the right femur and underwent Intralesional excision, internal fixation, bone grafting, and spica casting. At the age of 10, the girl came to our hospital again for severe pain of the right leg. Amputation from the middle level of the right femur was performed.
CONCLUSION
In our opinion, education on preventing pathological fractures and explaining the consequent serious consequences to the parents is a matter of prime significance. At the same time, prophylactic treatment (restricted exercise, support, or surgery) is also considerable for JSC.
PubMed: 38660072
DOI: 10.12998/wjcc.v12.i10.1785 -
Data in Brief Jun 2024Experimental and computational data are presented for Areolas da Estefania, a geomaterial which is crucial for the development of the underground infrastructure of the...
Experimental and computational data are presented for Areolas da Estefania, a geomaterial which is crucial for the development of the underground infrastructure of the city of Lisbon, Portugal. The experimental data comprise the particle size distribution of the material and measurements obtained during a series of strain-controlled triaxial compression tests performed on intact samples. The behaviour of this material at a wide range of strains, under constant mean effective stress levels of 130 kPa, 300 kPa and 400 kPa is established, with the presented dataset containing information on stress (mean effective stress and deviatoric stress) and strain states (axial strain and volumetric strain). These are complemented by the results of bender element tests imposing vertically-travelling waves for characterisation at very small strains. Complementarily, the computational dataset establishes a reference reproduction of the response of Areolas da Estefania using a material model which combines a non-linear small stiffness formulation with a state-dependent strength and plastic dilatancy. Overall, this dataset can be used as a reference when assessing the behaviour of other samples of Areolas da Estefania or comparable materials, or when evaluating constitutive models for granular geomaterials.
PubMed: 38654743
DOI: 10.1016/j.dib.2024.110391 -
Genetics Jun 2024Nanostructures of pores and protrusions in the insect cuticle modify molecular permeability and surface wetting and help insects sense various environmental cues....
Nanostructures of pores and protrusions in the insect cuticle modify molecular permeability and surface wetting and help insects sense various environmental cues. However, the cellular mechanisms that modify cuticle nanostructures are poorly understood. Here, we elucidate how insect-specific Osiris family genes are expressed in various cuticle-secreting cells in the Drosophila head during the early stages of cuticle secretion and cover nearly the entire surface of the head epidermis. Furthermore, we demonstrate how each sense organ cell with various cuticular nanostructures expressed a unique combination of Osiris genes. Osiris gene mutations cause various cuticle defects in the corneal nipples and pores of the chemosensory sensilla. Thus, our study emphasizes on the importance of Osiris genes for elucidating cuticle nanopatterning in insects.
Topics: Animals; Drosophila Proteins; Drosophila melanogaster; Sensilla; Multigene Family; Mutation; Nanostructures; Drosophila
PubMed: 38652268
DOI: 10.1093/genetics/iyae065 -
Cancer Management and Research 2024In the vast expanse of restorative surgical procedures, the Deep Inferior Epigastric Perforator (DIEP) flap, originating from the inferior epigastric artery, has emerged...
In the vast expanse of restorative surgical procedures, the Deep Inferior Epigastric Perforator (DIEP) flap, originating from the inferior epigastric artery, has emerged as the preferred method of breast reconstruction, attributable to its myriad advantages. The technique provides reliable vascular supply, robust tissue volume for excision, minimal invasiveness to the donor site, with direct closure and concealment of the said site. This paper embarks on an elaborate elucidation of the DIEP surgical procedure, pivoting on the analytical exploration of a particular instance where necrosis of the skin flap occurred following immediate DIEP breast reconstruction in a patient diagnosed with early-stage breast cancer. This patient had previously undergone Nipple Areola Complex Sparing Mastectomy (NSM). We endeavor to extrapolate insights from this singular case of post-NSM DIEP breast reconstruction failure and correlate our findings with current literature dedicated to similar instances of surgical failure in DIEP breast reconstruction.
PubMed: 38650978
DOI: 10.2147/CMAR.S429782 -
BMC Medical Informatics and Decision... Apr 2024This study aims to build a machine learning (ML) model to predict the recurrence probability for postoperative non-lactating mastitis (NLM) by Random Forest (RF) and...
OBJECTIVES
This study aims to build a machine learning (ML) model to predict the recurrence probability for postoperative non-lactating mastitis (NLM) by Random Forest (RF) and XGBoost algorithms. It can provide the ability to identify the risk of NLM recurrence and guidance in clinical treatment plan.
METHODS
This study was conducted on inpatients who were admitted to the Mammary Department of Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine between July 2019 to December 2021. Inpatient data follow-up has been completed until December 2022. Ten features were selected in this study to build the ML model: age, body mass index (BMI), number of abortions, presence of inverted nipples, extent of breast mass, white blood cell count (WBC), neutrophil to lymphocyte ratio (NLR), albumin-globulin ratio (AGR) and triglyceride (TG) and presence of intraoperative discharge. We used two ML approaches (RF and XGBoost) to build models and predict the NLM recurrence risk of female patients. Totally 258 patients were randomly divided into a training set and a test set according to a 75%-25% proportion. The model performance was evaluated based on Accuracy, Precision, Recall, F1-score and AUC. The Shapley Additive Explanations (SHAP) method was used to interpret the model.
RESULTS
There were 48 (18.6%) NLM patients who experienced recurrence during the follow-up period. Ten features were selected in this study to build the ML model. For the RF model, BMI is the most important influence factor and for the XGBoost model is intraoperative discharge. The results of tenfold cross-validation suggest that both the RF model and the XGBoost model have good predictive performance, but the XGBoost model has a better performance than the RF model in our study. The trends of SHAP values of all features in our models are consistent with the trends of these features' clinical presentation. The inclusion of these ten features in the model is necessary to build practical prediction models for recurrence.
CONCLUSIONS
The results of tenfold cross-validation and SHAP values suggest that the models have predictive ability. The trend of SHAP value provides auxiliary validation in our models and makes it have more clinical significance.
Topics: Humans; Female; Machine Learning; Adult; Recurrence; Mastitis; Middle Aged; Postoperative Complications; China
PubMed: 38649879
DOI: 10.1186/s12911-024-02499-y -
Scientific Reports Apr 2024In this article, we present a modification of the NS/SRM technique in which the mastopexy design for skin reduction is undertaken with a wide-base bipedicled (WIBB)...
In this article, we present a modification of the NS/SRM technique in which the mastopexy design for skin reduction is undertaken with a wide-base bipedicled (WIBB) flap. The WIBB flap can be applied in both autologous and implant-based breast reconstruction. Our reconstructive algorithm is also presented. The clinical data of patients operated on from June 2017 to November 2022 were collected: 51 patients for a total of 71 breasts. Personal data, BMI, type and volume of implants used, and major and minor complications were analyzed by descriptive statistics. The mean age was 48.3 years. BMI ranged between 21.5 and 30.9 kg/m. Thirty-one patients underwent unilateral mastectomy, while twenty patients underwent bilateral surgery. In 25 breasts, immediate reconstruction was performed with implants and ADM. In 40 breasts, reconstruction was performed with a subpectoral tissue expander, and in 6 breasts, reconstruction was performed with a DIEP flap. We observed only one case (1.4%) of periprosthetic infection requiring implant removal under general anesthesia. Minor complications occurred in 14.1% of patients. The use of both the WIBB flap and our algorithm maintained a low complication rate in our series, ensuring oncological radicality and a good aesthetic result at the same time.
Topics: Humans; Female; Middle Aged; Surgical Flaps; Mastectomy; Mammaplasty; Nipples; Adult; Breast Neoplasms; Aged; Postoperative Complications
PubMed: 38649704
DOI: 10.1038/s41598-024-52396-7 -
Brazilian Journal of Otorhinolaryngology Apr 2024Endoscopic thyroidectomy, such as axillary, areola and transoral approaches, offer the advantage of a good cosmetic outcome, but it requires a wider dissection field...
OBJECTIVE(S)
Endoscopic thyroidectomy, such as axillary, areola and transoral approaches, offer the advantage of a good cosmetic outcome, but it requires a wider dissection field compared to open thyroidectomy. Recently, chest-collarbone approach thyroidectomy has been widely developed in China because of its shorter anatomical route compared to other endoscopic approaches. This study retrospectively evaluated endoscopic thyroidectomy via chest-collarbone approach in patients with thyroid nodules to determine its feasibility.
METHODS
A total of 46 patients with thyroid disease who underwent endoscopic thyroidectomy between January 2022 and December 2022 were enrolled in the study and randomly matched to patients with thyroid disease who underwent open thyroidectomy at the same time based on nodule size and pathology. Postoperative bleeding, hoarseness situation, hospital stay, postoperative drainage volume, laryngeal nerve palsy, hypoparathyroidism and wound infection were assessed in both groups.
RESULTS
Forty-four patients underwent endoscopic thyroidectomy successfully and two patients changed to open thyroidectomy. The amount of postoperative drainage for the endoscopic thyroidectomy group was 102.78 ± 28.04 mL, and which was 71.91 ± 19.20 for open thyroidectomy group (p < 0.001). The postoperative hospital stay for the endoscopic thyroidectomy group was 8.78 ± 2.57 days, and which was 7.22 ± 1.13 for open thyroidectomy group (p < 0.001). There was no significant difference in postoperative bleeding, hoarseness situation, and wound infection between the two groups. Laryngeal nerve palsy, supraclavicular nerve injury and hypoparathyroidism were not observed in any patient during this study.
CONCLUSION
Chest-collarbone endoscopic thyroid surgery is acceptable. This treatment improves in a good cosmetic outcome in patients with thyroid disease. To assess patients with preoperative nodule size and nature of the case is the impact of the success rate, which is particularly important.
PubMed: 38636287
DOI: 10.1016/j.bjorl.2024.101429 -
Acta Medica Portuguesa Apr 2024
Topics: Female; Humans; Mastodynia; Nipples; Breast Feeding; Vascular Diseases
PubMed: 38631051
DOI: 10.20344/amp.20810