Identification of the Optimal Recipient Layer for Transplanted Fat: A Prospective Study on Breast Lipoaugmentation

2018 ◽  
Vol 39 (10) ◽  
pp. 1071-1081 ◽  
Author(s):  
Xiaoshuang Guo ◽  
Dali Mu ◽  
Wenshan Xing ◽  
Yaping Qu ◽  
Jie Luan
Keyword(s):  
Patient Satisfaction ◽  
Prospective Study ◽  
Retention Rate ◽  
Well Being ◽  
Retention Rates ◽  
Prospective Clinical Study ◽  
Pectoralis Muscle ◽  
Recipient Site ◽  
Minimal Invasiveness ◽  
Volume Retention

Abstract Background Fat grafting has become a popular procedure in aesthetic and reconstructive surgeries due to its safety, minimal invasiveness, and favorable visual outcomes, although the volume retention rate is unpredictable. Objectives A prospective clinical study on lipoaugmentation of the breast was conducted to compare fat retention rates in the pectoralis muscle and the periglandular area. Methods This prospective study included 20 breasts from 11 patients who underwent primary lipoaugmentation. Volume retention rate and percentage augmentation among different recipient layers, as well as complications and patient satisfaction, were evaluated. Magnetic resonance imaging was performed preoperatively and at 1 day and 3 months postoperatively. Complications were recorded, and patient satisfaction was appraised through the use of the Breast-Q questionnaire. Results Breasts were injected with 207 ± 29 mL of fat, achieving overall volume retention rates of 56.63% ± 16.40%. The overall augmentation was 21.53% ± 10.27%. Volume retention rate was significantly higher (59.00% ± 13.84%) in the periglandular area than in the pectoralis muscle (47.21% ± 22.41%) (P = 0.04). Augmentation was significantly higher (32.13% ± 12.96%) in the periglandular area than in the pectoralis muscle (4.95% ± 4.23%) (P = 0.00). Pain and numbness were the only reported complications. The Breast-Q score increased significantly for the measures “satisfaction with breasts,” “psychosocial well-being,” and “sexual well-being.” Conclusions Fat transfer is a safe and acceptable method for aesthetic and reconstructive breast surgery. The periglandular area was a better recipient site than muscle for transferred fat. Level of Evidence: 4

Is Volume Retention of the Breast Affected by Menstrual Cycle Phase at the Time of Autologous Fat Grafting?

2020 ◽  
Vol 40 (12) ◽  
pp. 1301-1308
Author(s):  
Keke Wang ◽  
Dali Mu ◽  
Xiaoyu Zhang ◽  
Yan Lin
Keyword(s):  
Menstrual Cycle ◽  
Breast Augmentation ◽  
Retention Rate ◽  
Fat Grafting ◽  
Retention Rates ◽  
Autologous Fat ◽  
Group A ◽  
Group B ◽  
Fat Volume ◽  
Volume Retention

Abstract Background Autologous fat grafts are commonly employed in plastic surgery, especially for aesthetic breast augmentation. However, it is difficult to predict the postoperative fat volume retention rate. Objectives The authors conducted a retrospective study comparing the fat volume retention rates of breast lipoaugmentation performed during different phases of the menstrual cycle. Methods The study included patients who underwent autologous fat grafting (AFG) breast augmentation from January 2012 to December 2018. Forty-eight individuals (94 breasts) were separated into 3 groups according to their menstrual stage: Group A: 10 patients (18 breasts); follicular group (end of menstruation to approximately 10 days); Group B: 15 patients (30 breasts); ovulatory group (11-17 days); Group C: 23 patients (46 breasts); luteal group (approximately 18 days to the next menstrual cramps). Results Mean age, menarche age, menstrual cycle, menstruation, and body mass index were comparable among the groups (P > 0.05). Patients with a history of lactation were comparable among the groups (Group A, 50%; Group B, 53.33%; Group C, 43.48%, P > 0.05). The overall volume retention rate of patients who underwent AFG during ovulation was significantly higher (Group A, 26.94%; Group B, 49.06%, Group C, 35.73%, P = 0.023), with no significant difference in volume retention rates between the follicular and luteal phases (P > 0.05). Conclusions Fat volume retention rates were higher when AFG breast augmentation was performed during ovulation, providing a new direction to improve long-term retention rates of autologous fat grafts. However, due to the small sample size, incomplete medical records, and lack of test data, further research is needed. Level of Evidence: 4

72: Quality of Life and Patient Satisfaction of Care Among Women with Urinary Incontinence: A Prospective Study

2007 ◽  
Vol 177 (4S) ◽  
pp. 25-26
Author(s):  
Simon Kim ◽  
Rodney L. Dunn ◽  
Edward J. McGuire ◽  
John O.L. DeLancey ◽  
John T. Wei
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Patient Satisfaction ◽  
Prospective Study ◽  
A Prospective Study

Clinical utility of Shabda and Sparsha Pareeksha in evaluation of Prakruta and Vaikruta Garbhavastha

2016 ◽  
Vol 1 (2) ◽  
Author(s):  
Priyanka T K ◽  
V.N. K. Usha ◽  
Sucheta Kumari M
Keyword(s):  
Clinical Study ◽  
Clinical Utility ◽  
Neonatal Outcome ◽  
Predictive Accuracy ◽  
Cost Effective ◽  
Well Being ◽  
Prospective Clinical Study ◽  
Clinical Tool ◽  
Accuracy Rate ◽  
Fetal Pathology

Garbha is a conglomeration of biological mass with different strata including consciousness, needs an innovative clinical tool to evaluate its well being, which proves safe, potent, cost-effective and noninvasive. The idea of taking up this study was to sensitively predict the Prakrutavastha or well being w.r.t Garbha-pushti and ongoing Fetal Pathology, Vaikrutavastha w.s.r Garbhavyapads for a sharp interference to get a possible best neonatal outcome. The objective of this study was to calculate the predictive accuracy of evaluation of Garbhaspandanam on external Shabda and Sparsha Pareeksha. A Prospective Clinical study of Garbhaspandanam (FHS and FM) with external Shabda and Sparsha stimulation on maternal abdomen, from 24th week onwards was conducted in a cohort of 30 Singleton Pregnant women at Dept. of Prasuti Tantra and Stri Roga, S.D.M.C.A. Hospital, Udupi. Among the 9 cases in abnormal category, 2 cases had gone for IUD and one case though placed in abnormal category had responded relatively well to Shabda and Sparsha Pareeksha which may be due to the proper antenatal care and intervention given along with the patient’s Vatakara Nidana Parivarjana. Predictive Accuracy Rate on Shabda and Sparsha Pareeksha showed, FHS 70%, FM 76.7%; FHS 73.3%, FM 66.7% respectively. Shabda and Sparshapareeksha can be utilized as the Garbha - chetana - dyodakalakshana and can be performed as a routine antenatal bedside procedure, which can fairly detect the Prakruta and Vaikrutavastha of Garbha w.r.t Pushti. However larger prospective studies are required.

Assessing Screenshots: An in-school evaluation of a middle-school digital citizenship curriculum (Preprint)

2020 ◽  
Author(s):  
David S. Bickham ◽  
Summer Moukalled ◽  
Heather Inyart ◽  
Rona Zlokower
Keyword(s):  
Conflict Resolution ◽  
New England ◽  
Comparison Group ◽  
Well Being ◽  
School Curriculum ◽  
Retention Rates ◽  
Digital Citizenship ◽  
Online Bullying ◽  
Online Interactions ◽  
Post Test

BACKGROUND Screenshots is an in-school curriculum that uses aspects of digital citizenship to develop the emerging digital social skills of middle-schoolers with the long term goal of improving their health and well-being. The program seeks to create a knowledge base on which young adolescents can build a set of beliefs and behaviors that foster respectful interactions, prosocial conflict resolutions, and safe and secure uses of communication technology. Intervening in this way can improve mental health by limiting their exposure to cyberbullying and other forms of negative online interactions. This study reports on an evaluation of Screenshots conducted with 7th graders in a public school system of a mid-size New England City. OBJECTIVE The goal of this study is to determine the effectiveness of the Screenshots program in increasing participants’ knowledge about key concepts of digital citizenship and in shifting beliefs and intended behaviors to align with pro-social, respectful, and safe online interactions. Additionally, the study examines the extent to which the program has differing effects for boys and girls in terms of their conflict and bullying resolution strategies. METHODS This quasi-experimental evaluation was conducted in four middle schools in which one group of 7th graders received the Screenshots curriculum and another did not. Before and after the curriculum, all students completed a questionnaire that measured their knowledge of and beliefs about digital citizenship and related online behavioral concepts, their attitudes regarding strategies for stopping online bullying, and their intended online conflict resolution behaviors. RESULTS The sample included 92 students who received the curriculum and 71 in the comparison group. Pre- to post-test retention rates ranged from 52.4% to 84% varying by school and condition. Results showed an increase in knowledge about key curricular concepts for some students (F1,32= 9.97, P = .003). In response to some individual items, student increased their beliefs supportive of online privacy (F1,42= 4.389, P=.04) and safety (F1,76= 2.79, P=.099) compared to the comparison group. Gender moderated the results related to conflict resolution with some boys reducing their endorsement of an aggressive option (F2,40= 5.77, P = .006), and some girls increasing their tendency to pursue a non-aggressive option (pre-test=3.83, post-test=3.58). Participants, on average, reported learning something new from the classes. CONCLUSIONS This study represents a rare evaluation of an in-school digital citizenship program and demonstrates the effectiveness of Screenshots. Students’ increased knowledge of key curricular concepts represents a foundation on which to develop future beliefs and healthy behaviors. Differences in how boys and girls experience and perpetrate online aggression likely explain the conflict resolution findings and emphasizes the need to examine gender differences in response to these programs. Students high rating of the relevance of Screenshot’s content reinforces the need for this type of intervention.

A Systematic Review on Extracellular Vesicles-Enriched Fat Grafting: A Shifting Paradigm

2020 ◽  
Author(s):  
Mohammad Ghiasloo ◽  
Laura De Wilde ◽  
Kashika Singh ◽  
Patrick Tonnard ◽  
Alexis Verpaele ◽  
...  
Keyword(s):  
Systematic Review ◽  
Graft Survival ◽  
Extracellular Vesicles ◽  
Retention Rate ◽  
Fat Grafting ◽  
Retention Rates ◽  
Fat Graft ◽  
Cochrane Central Register

Abstract Background Recent evidence confirms that mesenchymal stem cells (MSCs) facilitate angiogenesis mainly through paracrine function. Extracellular vesicles (EVs) are regarded as key components of the cell secretome, possessing functional properties of their source cells. Subsequently, MSC-EVs have emerged as a novel cell-free approach to improve fat graft retention rate. Objectives To provide a systematic review of all studies reporting the use of MSC-EVs to improve graft retention rate. Methods A systematic search was undertaken using the Embase, PubMed and the Cochrane Central Register of Controlled Trials databases. Outcome measures included donor/receptor organism of the fat graft, study model, intervention groups, evaluation intervals, EV research data, in vitro and in vivo results. Results Of the total 1717 articles, 62 full-texts were screened. Seven studies reporting on 294mice were included. Overall, EV treated groups showed higher graft retention rates compared to untreated groups. Notably, retention rate was similar following EV- and MSC-treatment. In addition to reduced inflammation, graft enrichment with EVs resulted in early revascularization and better graft integrity. Interestingly, hypoxic preconditioning of MSCs improved their beneficial paracrine effects and led to a more proangiogenic EV population, as observed by both in vitro and in vivo results. Conclusions MSC-EVs appear to offer an interesting cell-free alternative to improve fat graft survival. While their clinical relevance remains to be determined, it is clear that not the cells, but their secretome is essential for graft survival. Thus, a paradigm shift from cell-assisted lipotransfer towards ‘secretome-assisted lipotransfer’ is well on its way.

scholarly journals Near-falls in Singapore community-dwelling older adults: a feasibility study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Shawn Leng-Hsien Soh ◽  
Chee-Wee Tan ◽  
Judith Lane ◽  
Ting-Ting Yeh ◽  
Benjamin Soon
Keyword(s):  
Older Adults ◽  
Retention Rate ◽  
Community Dwelling ◽  
Retention Rates ◽  
Reach To Grasp ◽  
Balance Recovery ◽  
Recruitment And Retention ◽  
Body Regions ◽  
Near Falls ◽  
Community Dwelling Older Adults

Abstract Background A near-fall is defined as a loss of balance that would result in a fall if sufficient balance recovery manoeuvres are not executed. Compared to falls, near-falls and its associated balance recovery manoeuvres have been understudied. Older adults may not recognise a near-fall or identify the use of their balance recovery manoeuvres to prevent a fall. The consensus on the methods to collect near-fall data is lacking. The primary objective of this study was to determine the feasibility of recruitment and retention. Secondary objectives were to establish evidence that Singapore community-dwelling older adults can identify near-falls and associated balance recovery manoeuvres. Texting and calling methods were explored as reporting methods. Methods This study took place in Singapore (September to October 2019). Participants were healthy, community-dwelling adults aged 65 or older. Recruitment was done through poster advertisement, and all participants gave informed consent. Participants attended a briefing session and reported their near-fall or fall incidence over 21 days using either daily texting or calling. The primary outcome measures were the recruitment rate, retention rate, preferred modes for data reporting and ability to report near-falls or falls. Secondary outcomes included the self-reported incidence of falls and near-falls. Results Thirty older adults were recruited in 5 weeks. All participants completed the study. They understood near-fall concepts and were able to report the occurrence and relevant balance recovery manoeuvres used to prevent a fall. 87% (26/30) chose to text while 13% (4/30) selected calling as their reporting method. One actual fall (0.16%) out of 630 responses was reported. Thirty-six incidents (5.7%) of near-falls were recorded. Sixteen participants (53.3%) experienced near-falls and half of this group experienced two or more near-falls. The use of reach-to-grasp strategy (36%), compensatory stepping (52.8%), and other body regions (11.2%) were used to prevent the fall. Conclusions The study provided evidence that studying near-falls in Singapore community-dwelling older adults is feasible and can be applied to a large-scale study. Recruitment and retention rates were good. Older adults were able to identify near-falls and balance recovery manoeuvres. Both texting and calling were feasible reporting methods, but texting was preferred. Trial registration ClinicalTrials identifier: NCT04087551. Registered on September 12, 2019

scholarly journals 907 Reduction of Nasal Fractures During COVID-19: A Single-Centre Experience

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
T Crotty ◽  
M Corbett ◽  
T Hussain ◽  
A Diaconescu ◽  
N Patil
Keyword(s):  
Patient Satisfaction ◽  
Prospective Study ◽  
Local Anaesthetic ◽  
Regional Anaesthesia ◽  
Effective Alternative ◽  
General Anaesthetic ◽  
Single Centre ◽  
Pain Scores ◽  
Single Centre Experience ◽  
Nasal Fractures

Abstract Introduction The utilization of local or regional anaesthesia for manipulation of nasal fractures (MNF) avoids the need for general anaesthetic (GA), and the risk associated with instrumentation of the airway during the COVID-19 pandemic. Furthermore, MNF under local anaesthetic (LA) provides similar results with regards to cosmesis and patient satisfaction. We present our experience of performing MNF under LA during the COVID-19 pandemic. Method A single-centre, prospective study of all patients undergoing MNF under LA was conducted (13th July/20–11thSeptember/20). Following reduction, pain scores and patient satisfaction surveys were administered. Results A total of 25 patients (M/F:16/9, median age, 25.6yr (14-52yr)) were enrolled. The majority of patients received either one or two instillations of LA (n = 19, 76%). Pain reported during the MNF procedure was 4.4/10, whilst pain during LA administration was reported as 3.2/10. 80% of patients felt instillation of LA was less painful than expected. 88% of respondents tolerated the LA well, and only 8% would have opted for general anaesthetic. 24 (96%) participants were happy with the cosmetic result. Discussion MNF under LA is a safe and effective alternative to MNF under GA. More literature is needed to define the best method of administering LA prior to performing MNF.

Abstract TP292: Effect of Improved Management Strategies on Study Retention Rates

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Michael Dela Cruz ◽  
Kinga Aitken ◽  
Ka-Ho Wong ◽  
Theodore Rock ◽  
Jennifer J Majersik
Keyword(s):  
Clinical Research ◽  
Research Team ◽  
Retention Rate ◽  
Management Strategies ◽  
Retention Rates ◽  
Stroke Patients ◽  
Trial Duration ◽  
Implementation Period ◽  
Stroke Center ◽  
Stroke Trial

Introduction: Average national dropout rates of participants enrolled in a research trial are reported to be 30%. Factors contributing to loss of stroke patient retention include the lack of understanding of study expectations, lack of relationship building between patient and clinical research team, and inefficient management processes. There has been little research into interventions to improve retention. Focusing on these 3 factors may increase the likelihood of stroke patients adhering to and completing participation in stroke trials. The University of Utah Stroke Center became a StrokeNet regional coordinating center in October 2013. As study trials increased, we recognized the need to implement new trial management strategies and did so in January 2016. Methods: Stroke trial metrics were compared between the pre-implementation period (7/1/2012 - 12/31/2015) and a post-implementation period (1/7/2016 - 7/1/2019). The size of clinical research team personnel remained the same across the two periods: 4 coordinators and 9 physicians. Standardization of enrollment processes in stroke trials occurred during the post-implementation period. Three key aspects addressed in the post-implementation period were building rapport, setting realistic expectations, and properly educating patient and family members. The clinical research team incorporated these factors when approaching patients regardless of type of stroke trial (acute, subacute, or observational). Results: During the pre-implementation period, the Stroke Center research team managed 8 stroke studies with 52 patients consented with average trial duration of 23 months (SD); in the post-implementation period, there were 15 studies with 99 patients consented, with average trial duration of 22 months (SD). Retention improved after the intervention from a mean (SD) retention rate of 79.5 (29.7) %. to 90.8 (17.2) %. Although this difference was not significant, it represented meaningful change to the research staff and helped us achieve StrokeNet retention goals. Conclusion: Implementation of effective management strategies leads to higher retention rates of stroke patients despite no change in the size of the clinical research team.

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