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The Journal of Craniofacial Surgery Jun 2024Rib graft is a common source of cartilage in rhinoplasty. Donor site choices for this resource were identified according to the authors who presented the introduction of...
Rib graft is a common source of cartilage in rhinoplasty. Donor site choices for this resource were identified according to the authors who presented the introduction of this technique. However, the scientific basis of this valuable method lacks information, including the anatomical properties of costal cartilage. In this study, cartilage radioanatomy is examined and tested for if any estimators are present. A total of 148 thoracal CT scans of patients who applied to our facility were analyzed. Patients were divided per their sex and age of 35, and rib cartilage dimensions, including axial length between the sternal and costal ends of the cartilage (TotL), posteroanterior diameters at the sternal end (StDia), costal end (CosDia), the thickest part (MaxDia) as diametrical parameters and vertical height at the thickest part (h) were recorded. Length of the sternum (St), the axial length of the clavicle (ClavL), the distance of the sixth rib from the anterior axillary border (AntAx), and thorax circumferences at the level of both pectoralis major muscle origin (ThC) and nipples (BrC) were recorded. Statistical analyses were done for correlations. St, ClavL, ThC, and BrC were found to have the most correlated measurements in groups with the age of 35 and less of both genders, and the relations were lost in older groups. Thorax shape may change after the age of 35 years, but in younger patients, St in females and ClavL in males can be used as estimators of cartilage amount.
Topics: Humans; Costal Cartilage; Male; Female; Adult; Tomography, X-Ray Computed; Tissue and Organ Harvesting; Algorithms; Rhinoplasty; Ribs; Sternum; Clavicle; Middle Aged
PubMed: 38738902
DOI: 10.1097/SCS.0000000000010101 -
Archives of Plastic Surgery May 2024Several strategies for the management of venous congestion of the nipple-areola complex (NAC) after reduction mammaplasty have been proposed. Among these, hirudotherapy...
Several strategies for the management of venous congestion of the nipple-areola complex (NAC) after reduction mammaplasty have been proposed. Among these, hirudotherapy represents an ancient but still effective method, even though the risk of infections related to leeches should be considered. We report a peculiar case of breast infection and sepsis after leech therapy in a patient who underwent a reduction mammaplasty. A prompt surgical debridement of the wounds and necrotic tissues associated with targeted antibiotic therapy led to a fast improvement of clinical conditions, and partial preservation of the NAC was obtained. Accurate knowledge of the clinical presentation of soft tissue infections related to leeching allows for an early diagnosis and would serve as a warning for surgeons who approach such breast cosmetic procedures.
PubMed: 38737840
DOI: 10.1055/s-0043-1776696 -
Journal of Pediatric Nursing May 2024Breastfeeding technique is a combination of positioning, attachment, and breast milk suckling. Breastfeeding problems are caused by incorrect breastfeeding practices,...
BACKGROUND
Breastfeeding technique is a combination of positioning, attachment, and breast milk suckling. Breastfeeding problems are caused by incorrect breastfeeding practices, which lead to premature discontinuation of breastfeeding. Therefore, this study aimed to determine the proportion of breastfeeding techniques and associated factors among lactating primiparous mothers during the postpartum period in the Debre Markos town health facility in 2021.
METHODS
An institutional-based cross-sectional study was conducted from November 1st to December 30, 2021. A systematic sampling technique was utilized to select study participants. An observational checklist developed by WHO and an interviewer-administered questionnaire were used to collect data from 409 mothers. The collected data were entered into Epi-Data version 4.6.0.4 statistical software and then exported to SPSS version 24.0 for cleaning and analysis. Binary and multivariable logistic regression was carried out to identify the factors associated with the practice of effective breastfeeding techniques. A variable that has a p-value of ≤0.2 was transferred to a multivariable for further analysis. The strength of association was identified using an adjusted odds ratio with a 95% confidence interval, and a p-value <0.05 was taken as statistically significant.
RESULTS
The proportion of practicing effective breastfeeding techniques among lactating primipara mothers was 29.1% (CI: 24.7, 33.3). Baby aged ≥29 days, mothers who were living in urban, mothers who attended college or higher education, mothers who have heard about BFT practices, mothers who received counseling on BFT after delivery, and mothers whose breast nipples had everted were variables that were significantly associated with the practice of effective breastfeeding techniques.
CONCLUSION
The findings of this study revealed that the practice of effective breastfeeding techniques among lactating primipara mothers was lower in the study area. Therefore, healthcare providers should have to counsel mothers on how to position and attach their infants during breastfeeding.
PRACTICE IMPLICATION
The provision of breast-feeding method counseling to nursing mothers is one way to enhance the practices of breast feeding.
PubMed: 38729893
DOI: 10.1016/j.pedn.2024.05.010 -
Chest May 2024A newborn girl presented to the hospital on the first day of life because of respiratory failure. She was born at home at 37 weeks' gestation with minimal prenatal care...
A newborn girl presented to the hospital on the first day of life because of respiratory failure. She was born at home at 37 weeks' gestation with minimal prenatal care and was found to be small for gestational age. The patient was found to have partial sternal agenesis and sternal cleft, cutis aplasia, left facial hemangioma, micrognathia, wide-spaced nipples, and low-set ears. The mother's and baby's urine toxicology screening were positive for amphetamines. Chest radiographs on admission showed bilateral hazy opacities. CT scan of the chest showed an absent sternum with midline chest wall concavity. The patient was monitored preoperatively in the cardiac ICU for risks of arrythmia, respiratory failure, altered cardiac output, and acute cardiopulmonary decompensation.
Topics: Humans; Female; Sternum; Infant, Newborn; Abnormalities, Multiple; Tomography, X-Ray Computed; Hemangioma; Musculoskeletal Abnormalities
PubMed: 38724152
DOI: 10.1016/j.chest.2023.12.010 -
Journal of Plastic, Reconstructive &... Jun 2024
Topics: Humans; Nipples; Female; Esthetics; Mammaplasty; Adult; Middle Aged; Patient Preference; Patient Satisfaction
PubMed: 38714042
DOI: 10.1016/j.bjps.2024.04.017 -
Journal of Paediatrics and Child Health 2024Retroareolar cysts (RCs) are a benign self-resolving condition primarily affecting pubertal individuals. However, their presentation as asymptomatic bluish areolar lumps... (Review)
Review
Retroareolar cysts (RCs) are a benign self-resolving condition primarily affecting pubertal individuals. However, their presentation as asymptomatic bluish areolar lumps remains underreported in the literature, with only six cases previously documented. This lack of awareness may lead to the oversight of RCs during diagnosis. To address this, we conducted a comprehensive literature review using PUBMED, and we further added three more cases. The mean time for clinical resolution was found to be 2.3 years. In light of these findings, we proposed a diagnostic and management algorithm to guide clinicians in their approach to RCs in pediatric patients. The algorithm involves thorough clinical examination, medical history assessment, and echographic investigation with color Doppler analysis. Regular follow-up visits are recommended until resolution of the lesions. Notably, due to the consistently favorable outcome of RCs, aggressive diagnostic interventions can be avoided, providing reassurance to patients and their families. It is crucial for paediatricians to stay updated on this underreported condition to ensure timely recognition and appropriate management. Dermatologists should be the first specialists to be consulted in cases of suspected RCs. Increasing awareness among healthcare professionals will contribute to improved diagnosis and management of this benign condition. In conclusion, RCs are a benign self-resolving condition commonly observed during puberty. Their presentation as asymptomatic bluish areolar lumps may often be overlooked. Through this study, we highlighted the importance of early recognition, proposed a diagnostic and management algorithm, and emphasized the favorable prognosis of RCs, which allows for a conservative approach to their management.
Topics: Humans; Female; Adolescent; Puberty; Breast Cyst; Child; Algorithms; Diagnosis, Differential
PubMed: 38712575
DOI: 10.1111/jpc.16561 -
Journal of the European Academy of... May 2024Large to giant congenital melanocytic nevi (LGCMN) significantly decrease patients' quality of life, but the inaccuracy of current classification system makes their...
BACKGROUND
Large to giant congenital melanocytic nevi (LGCMN) significantly decrease patients' quality of life, but the inaccuracy of current classification system makes their clinical management challenging.
OBJECTIVES
To improve and extend the existing LGCMN 6B/7B classification systems by developing a novel LGCMN classification system based on a new phenotypic approach to clinical tool development.
METHODS
Three hundred and sixty-one LGCMN cases were categorized into four subtypes based on anatomic site: bonce (25.48%), extremity (17.73%), shawl (19.67%) and trunks (37.12%) LGCMN. A 'BEST' classification system of LGCMN was established and validated by a support vector machine classifier combined with the 7B system.
RESULTS
The most common LGCMN distributions were on bonce and trunks (bathing trunk), whereas breast/belly and body LGCMN were exceptionally rare. Sexual dimorphism characterized distribution, with females showing a wider range of lesions in the genital area. Nearly half of the patients with bathing trunk LGCMN exhibited a butterfly-like distribution. Approximately half of the LGCMN with chest involvement did not have nipple-areola complex involvement. Abdomen, back and buttock involvement was associated with the presence of satellite nevi (r = 0.558), and back and buttock involvement was associated with the presence of nodules (r = 0.364).
CONCLUSIONS
The effective quantification of a standardized anatomical site provides data support for the accuracy of the 6B/7B classification systems. The simplified BEST classification system can help establish a LGCMN clinical database for exploration of LGCMN aetiology, disease management and prognosis prediction.
PubMed: 38708780
DOI: 10.1111/jdv.20075 -
Plastic and Reconstructive Surgery.... May 2024We present a novel percutaneous areola reduction technique that, to our knowledge, has never been used or published in the past. This technique is a useful solution to...
We present a novel percutaneous areola reduction technique that, to our knowledge, has never been used or published in the past. This technique is a useful solution to the downsides of the current most commonly used technique for areola reductions that uses a circumareolar incision. Our current technique utilizes a percutaneous approach, which is a minimally invasive procedure, and produces a virtually scarless result.
PubMed: 38706471
DOI: 10.1097/GOX.0000000000005783 -
Arthropod Structure & Development May 2024Permopsocids are small acercarian insects with mouthparts specialized for sucking. They are closely related to Hemiptera and Thysanoptera. The earliest known...
Permopsocids are small acercarian insects with mouthparts specialized for sucking. They are closely related to Hemiptera and Thysanoptera. The earliest known representatives are from the Early Permian. Here evidence is presented that the Permopsocida occurred even earlier in Pennsylvanian (Moscovian) deposits in the Piesberg quarry near Osnabrück (Lower Saxony, Germany). This material is assigned to the Permian family Psocidiidae; Carbonopsocus mercuryi gen. et sp. nov., based on the wing venation diagnosed by the unique branching pattern of the main veins, the shape of the areola postica being longer than wide, the angular shape of the pterostigma, the ir crossvein directed proximally mid of pterostigma (apomorphy) and the vannus formed by the three veins of PCu, A1 and A2. The shape of the veins, with a Y-vein formed by the distal fusion of PCu with A1, could be a putative symplesiomorphy of the Psocodea with Permopsocida and Hemiptera. C. mercuryi gen. et sp. nov. is the first appearance date for Permopsocida and roots the Acercaria tree. In addition, another specimen of Dichentomum cf. arroyo (Psocidiidae) from Carrizo Arroyo is presented and figured, confirming the presence of the genus Dichentomum near the Carboniferous-Permian boundary and linking it to the Artinskian species from Elmo in Kansas, USA.
Topics: Wings, Animal; Animals; Insecta; Fossils; Germany
PubMed: 38704966
DOI: 10.1016/j.asd.2024.101358 -
Annals of Surgical Oncology May 2024Nipple-sparing mastectomy (NSM) is an oncologically safe approach for breast cancer treatment and prevention; however, there are little long-term data to guide...
BACKGROUND
Nipple-sparing mastectomy (NSM) is an oncologically safe approach for breast cancer treatment and prevention; however, there are little long-term data to guide management for patients whose nipple margins contain tumor or atypia.
METHODS
NSM patients with tumor or atypia in their nipple margin were identified from a prospectively maintained, single-institution database of consecutive NSMs. Patient and tumor characteristics, treatment, recurrence, and survival data were assessed.
RESULTS
A total of 3158 NSMs were performed from June 2007 to August 2019. Nipple margins contained tumor in 117 (3.7%) NSMs and atypia only in 164 (5.2%) NSMs. Among 117 nipple margins that contained tumor, 34 (29%) margins contained invasive cancer, 80 (68%) contained ductal carcinoma in situ only, and 3 (3%) contained lymphatic vessel invasion only. Management included nipple-only excision in 67 (57%) breasts, nipple-areola complex excision in 35 (30%) breasts, and no excision in 15 (13%) breasts. Only 23 (24%) excised nipples contained residual tumor. At 67 months median follow-up, there were 2 (1.8%) recurrences in areolar or peri-areolar skin, both in patients with nipple-only excision. Among 164 nipple margins containing only atypia, 154 (94%) nipples were retained. At 60 months median follow-up, no patient with atypia alone had a nipple or areola recurrence.
CONCLUSIONS
Nipple excision is effective management for nipple margins containing tumor. No intervention is required for nipple margins containing only atypia. Our results support broad eligibility for NSM with careful nipple margin assessment.
PubMed: 38691238
DOI: 10.1245/s10434-024-15362-1