Revolutionizing Breast Reconstruction: The Rise of Hybrid Techniques.

Hybrid breast reconstruction (HBR) combines autologous tissue and bio-prosthetic breast reconstruction techniques. This method addresses many challenges associated with stand-alone techniques, including inadequate volume with autologous reconstruction and esthetic issues like rippling in implant-based reconstruction. However, despite its promising advantages, HBR remains underutilized.

Surgeon Experience and Outcomes in Microsurgical Breast Reconstruction: A 10-Year Single Surgeon Analysis.

Microsurgical breast reconstruction with deep inferior epigastric perforator (DIEP) flaps has become increasingly popular. While surgeons undergo rigorous training, it is believed that plastic surgeons continue to refine and enhance their performance through independent practice. This study evaluates the effect of surgeon experience on clinical outcomes in DIEP flap breast reconstruction.

Tranexamic Acid in Reconstructive Microsurgery: A Systematic Review and Meta-Analysis.

Tranexamic acid (TXA) has gained popularity across various surgical specialties for reducing perioperative blood loss. However, its role in microsurgery remains underexplored, likely due to concerns that TXA may increase the risk of thromboembolic events and compromise flap viability. Therefore, the aim of this study was to determine the impact of TXA in microsurgical reconstructive procedures.

Infant Cleft-Lip Repair Under Local Anesthesia.

Cleft lip is the most common congenital facial abnormality in the world. Repair in the pediatric population is typically done under general anesthesia around 3 or 4 months of age, though general anesthesia at an early age may have adverse neurodevelopmental effects. This case report describes a novel instance of cleft lip repair in an infant done under local anesthesia in an office setting and talks about preoperative screening, procedural technique, and benefits of utilizing local anesthesia compared with general anesthesia.

Scar Management in Pediatric Patients.

: Pediatric patients can acquire scars from both accidental injury and surgical procedures. While scars cannot be avoided if a full-thickness injury occurs, scar visibility may be minimized through a variety of approaches. In this narrative review, we evaluate the current evidence and propose an algorithm for scar management in pediatric patients.

A randomized controlled trial: Evaluating whether a cognitive behavioral internet-delivered intervention targeting emotion regulation improves health-related quality of life in cancer survivors.

Objective: Cancer survivors experience reduced overall health-related quality of life (HRQoL) compared to the general population. This research assesses and compares the efficacy of an emotion-focused (CanCopeMind [CM]) and lifestyle (CanCopeLifestyle [CL]) intervention to improve HRQoL among cancer survivors.

Method: This 8-week, internet-delivered, randomized controlled trial compared CM ( = 110) and CL ( = 114) on self-reported HRQoL (range -0.

Sitting vs. standing: The impact of surgeon posture on patient perception of visit duration in the outpatient plastic surgery clinic.

Background: Patients commonly feel a medical professional spends more time with them when the provider is seated during a visit rather than standing. However, no empirical evidence supports this claim in the outpatient setting or specifically in plastic surgery clinics. This study aimed to provide quantitative evidence to support or refute this perception.

Evidence for a Causal Association Between Human Cytomegalovirus Infection and Chronic Back Pain: A One-Sample Mendelian Randomization Study.

Background: Chronic back pain (CBP) is a major cause of disability globally. While its etiology is multifactorial, specific contributing genetic and environmental factors remain to be discovered. Paraspinal muscle fat has been shown in human and preclinical studies to be related to CBP.

A standardized, open-source, portable model for noninvasive joint injury in mice.

Preclinical models of osteoarthritis (OA) are crucial for the study of disease mechanisms and for the development of critically-needed disease-modifying therapeutics. While surgical OA models, such as the destabilization of the medial meniscus (DMM), have been the gold standard in the field for decades, noninvasive joint loading-based models have increased in popularity and utility. To facilitate standardization of the noninvasive anterior cruciate ligament rupture (ACLR) model in mice, we present the bile oint-Injury perator - an open-source protocol with accompanying fixtures and data, designed for a low-cost, commercially-available, portable uniaxial testing system with a small footprint.

Cost-Effectiveness of Prophylactic Mastectomy and Autologous Flap Reconstruction in BRCA1/2+ Patients: A Markov Chain Monte Carlo Simulation Analysis.

Introduction: Patients diagnosed with Breast Cancer gene (BRCA) 1 or 2 face a critical choice between prophylactic mastectomy versus serial surveillance screening. This study aims to evaluate the cost-effectiveness of prophylactic mastectomy with autologous reconstruction compared to surveillance strategies for this patient population.

Methods: Markov Chain Monte Carlo (MCMC) simulations comprising 100,000 patients were used.

Frequency and timing of multiple skin cancer development in five cohorts.

Background: Many patients will develop more than one skin cancer; however, most research to date has examined only case status.

Objective: Describe the frequency and timing of the treatment of multiple skin cancers in individual patients over time.

Methods: We conducted a longitudinal claims and electronic health record-based cohort study to examine the frequency of skin cancer multiplicity.

Emotional Regulation in Substance-Related and Addictive Disorders Treatment: A Systematic Review.

Emotions play an undeniable role in addictive disorders. Given the high relapse and drop-out rates still prevalent in current treatments, it is crucial to explore curative alternatives that take greater account of emotions. The primary objective of this systematic review is to gather literature related to emotion regulation in psychological addictive disorders treatments.

The impact of imprecise case definitions in electronic health record research: a melanoma case-study from the Million Veteran Program.

Cases for a disease can be defined broadly using diagnostic codes, or narrowly using gold-standard confirmation that often is not available in large administrative datasets. These different definitions can have significant impacts on the results and conclusions of studies. We conducted this study to assess how using melanoma phecodes versus histologic confirmation for invasive or in situ melanoma impacts the results of a genome-wide association study (GWAS) using the Million Veteran Program.

Evaluating the Utility of ChatGPT in Diagnosing and Managing Maxillofacial Trauma.

Maxillofacial trauma is a significant concern in emergency departments (EDs) due to its high prevalence and the complexity of its management. However, many ED physicians lack specialized training and confidence in handling these cases, leading to a high rate of facial trauma referrals and increased stress on consult services. Recent advancements in artificial intelligence, particularly in large language models such as ChatGPT, have shown potential in aiding clinical decision-making.

The association of lumbar intervertebral disc degeneration with low back pain is modified by underlying genetic propensity to pain.

Background Context: Associations between magnetic resonance imaging (MRI)-detected lumbar intervertebral disc degeneration (LDD) and LBP are often of modest magnitude. This association may be larger in specific patient subgroups.

Purpose: To examine whether the association between LDD and LBP is modified by underlying genetic predispositions to pain.

Toward personalized skin cancer care: multiple skin cancer development in five cohorts.

Importance: Many patients will develop more than one skin cancer, however most research to date has examined only case status.

Objective: Describe the frequency and timing of the treatment of multiple skin cancers in individual patients over time.

Design: Longitudinal claims and electronic health record-based cohort study.

Voriconazole Metabolism is Associated with the Number of Skin Cancers Per Patient.

Voriconazole exposure is associated with skin cancer, but it is unknown how the full spectrum of its metabolizer phenotypes impacts this association. We conducted a retrospective cohort study to determine how variation in metabolism of voriconazole as measured by metabolizer status of CYP2C19 is associated with the total number of skin cancers a patient develops and the rate of development of the first skin cancer after treatment. There were 1,739 organ transplant recipients with data on CYP2C19 phenotype.

A report on the safety of acitretin use in patients with renal failure on haemodialysis.

Acitretin, commonly used for severe psoriasis and keratinocyte carcinoma chemoprevention in high-risk patients, is contraindicated in patients with end-stage renal disease (ESRD) on haemodialysis (HD). However, these patients often lack medication choices and in certain clinical scenarios the benefits of acitretin may outweigh the potential risks. We identified 24 patients with ESRD on HD undergoing acitretin treatment from the Duke and Vanderbilt University Medical Centers.

Modic change is associated with increased BMI but not autoimmune diseases in TwinsUK.

Purpose: Low back pain (LBP) is one of the largest causes of morbidity worldwide. The aetiology of LBP is complex, and many factors contribute to the onset. Bone marrow lesions within the vertebra adjacent to an intervertebral degenerate disc named Modic change (MC) have been suggested as a diagnostic subgroup of LBP.

Targeting emotional regulation using an Internet-delivered psychological intervention for cancer survivors: A randomized controlled trial.

Objectives: This trial assessed the efficacy of an emotion-focused, modular, Internet-delivered adaptation of the Unified Protocol (UP) in improving cancer survivors' emotion regulation strategies.

Design: A two-arm randomized controlled trial (1:1) was used to compare the efficacy of two Internet-based interventions: UP-adapted CanCope Mind (CM) and lifestyle-focused active control CanCope Lifestyle (CL).

Methods: N = 224 cancer survivors randomized to CM or CL were assessed at baseline, between-modules, at post-intervention and 3-month follow-up on emotion regulation outcomes targeted by each CM module (Module 1: beliefs about emotions; Module 2: mindfulness; Module 3: cognitive reappraisal skills, catastrophizing, refocus on planning; Module 4: experiential avoidance).