scholarly journals The Kinematics of Breasts Implanted With a Reduced Mass Implant: A Pilot Study

2019 ◽  
Vol 40 (5) ◽  
pp. NP253-NP262 ◽  
Author(s):  
Michelle Norris ◽  
Melissa Jones ◽  
Chris Mills ◽  
Tim Blackmore ◽  
Chris Inglefield ◽  
...  
Keyword(s):  
Pilot Study ◽  
Breast Implants ◽  
Breast Size ◽  
Level Of Evidence ◽  
Dynamic Activity ◽  
Electromagnetic Sensors ◽  
Skin Tension ◽  
Natural Counterpart ◽  
Positional Data ◽  
Insight Into

Abstract Background Breast implants may increase breast skin tension and interact with surrounding tissues to alter breast position and motion during dynamic activity. Reducing implant mass and changing implant location (submuscular/subglandular) may also affect breast kinematics and the subsequent loads on breast structures. Objectives The aim of this pilot study was to describe the kinematics of breasts augmented with reduced-mass implants during standing, walking, and running, compared with natural breasts, and to provide insight into how implant location (submuscular/subglandular) alters breast kinematics. Methods Two breast augmentation participants (12–15 months postsurgery: 32AA presurgery, anatomical submuscular 255 cc B-Lite reduced-mass implant; 32A presurgery, anatomical subglandular 285 cc B-Lite reduced-mass implant) and 2 natural-breasted participants of similar breast size and anthropometrics were recruited. Nipple and torso positional data were recorded with electromagnetic sensors during standing, walking, and running. Nipple kinematics relative to the torso were calculated. Results The B-Lite participants both displayed greater nipple projection and elevation during standing and a 50% reduction in nipple acceleration during walking, when compared with their natural counterparts. During running, the B-Lite subglandular participant displayed decreased nipple kinematics compared with her natural counterpart and lower nipple kinematics compared with the B-Lite submuscular participant during walking and running. Conclusions A combination of implant location (subglandular) and reduced mass minimized nipple kinematics during running. Reducing nipple kinematics during dynamic activity may decrease the loading on breast structures, helping to decrease ptosis and increase the longevity of procedure outcomes. Level of Evidence: 4

Comparative Analysis of Cytokines of Tumor Cell Lines, Malignant and Benign Effusions Around Breast Implants

2019 ◽  
Vol 40 (6) ◽  
pp. 630-637 ◽  
Author(s):  
Marshall E Kadin ◽  
John Morgan ◽  
Nick Kouttab ◽  
Haiying Xu ◽  
William P Adams ◽  
...  
Keyword(s):  
Breast Implant ◽  
Breast Implants ◽  
Interferon Γ ◽  
Textured Surface ◽  
Malignant Cells ◽  
Level Of Evidence ◽  
Scar Contracture ◽  
Ancillary Test ◽  
Soluble Cd30 ◽  
Insight Into

Abstract Background More than 700 women have developed an anaplastic large T cell lymphoma (ALCL) surrounding textured surface breast implants, termed breast implant–associated ALCL (BIA-ALCL). Most patients with BIA-ALCL present with an accumulation of fluid (delayed seroma) around the implant. However, benign seromas without malignant cells complicating scar contracture, implant rupture, trauma, infection, and other causes are more common. For proper patient management and to avoid unnecessary surgery, a simple diagnostic test to identify malignant seromas is desirable. Objectives The aim of this study was to develop an ancillary test for the diagnosis of malignant seromas and to gain insight into the nature of the malignant cells and their microenvironment. Methods We employed an immunologic assay on only 50 µL of aspirated seroma fluid. The assay measures 13 cytokines simultaneously by flow cytometry. To establish a baseline for clinical studies we measured cytokines secreted by BIA-ALCL and cutaneous ALCL lines. Results Our study of cell line culture supernatants, and 8 malignant compared with 9 benign seromas indicates that interleukin 9 (IL-9), IL-10, IL-13, IL-22, and/or interferon γ concentrations >1000 pg/mL distinguish malignant seromas from benign seromas. IL-6, known to be a driver of malignant cells, is also elevated in benign seromas and does not distinguish them from malignant seromas. Conclusions The cytokine assay introduced in this study can be used together with levels of soluble CD30 to identify malignant seromas. Validation of these findings in a larger prospective patient cohort is warranted. The unique pattern of cytokine expression in malignant effusions surrounding breast implants gives further insight into the pathogenesis and cells of origin of BIA-ALCL. Level of Evidence: 5

scholarly journals Good Idea But Not Here! A Pilot Study of Swedish Tourism Stakeholders’ Perceptions of Halal Tourism

2021 ◽  
Vol 13 (5) ◽  
pp. 2646
Author(s):  
Saeid Abbasian
Keyword(s):  
Content Analysis ◽  
Pilot Study ◽  
Tourism Industry ◽  
Target Group ◽  
Exploratory Research ◽  
Swedish Study ◽  
Increased Risk ◽  
Insight Into

The following study is the first Swedish study on Halal tourism in Sweden. The purpose of this exploratory research is to get insight into the perception of Halal tourism in Sweden among representatives of tourism stakeholders. The overall methodology approach in this research is qualitative, consisting of 25 qualitative questionnaires, 21 short letters, four follow-up interviews, and a web observation, and content analysis was employed. The results indicate that there is a low knowledge of Halal tourism in Sweden including Swedish tourism industry. The concept is very challenging, and profits are low. It might result in problem scenarios such as detrimental effects on non-Halal tourism, cultural difficulties and increased risk of xenophobia, anti-Islamism, and tension in the society. There is low interest for Sweden among Muslim tourists as the interest and priority for Halal tourism is rather low from Swedish tourism industry. Despite Halal tourism’s importance internationally, these representatives are rather cautious and doubtful about promotion of Sweden towards this niche. Still, a majority seems to be positive to a lighter version of Muslim-friendly tourism with secular/moderate Muslims as a target group.

scholarly journals The Reported Use of Tongue-Ties and Nosebands in Thoroughbred and Standardbred Horse Racing—A Pilot Study

Animals ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 622
Author(s):  
Dominic Weller ◽  
Samantha Franklin ◽  
Peter White ◽  
Glenn Shea ◽  
Kate Fenner ◽  
...  
Keyword(s):  
Risk Factor ◽  
Pilot Study ◽  
Airway Obstruction ◽  
Positive Association ◽  
Common Reason ◽  
Horse Racing ◽  
Equal Importance ◽  
Potential Risks ◽  
Equine Industry ◽  
Insight Into

This article reports on the results of a survey of racehorse trainers (n = 112) outlining the reasons for tongue-tie (TT) and noseband (NB) use by Thoroughbred trainers (TBTs) (n = 72) and Standardbred trainers (SBTs) (n = 40). The study also investigated the reported effectiveness of TTs and possible complications arising from their use. Tongue-tie use was reported by 62.5% (n = 70) of racehorse trainers. The reasons for TT use varied between TBTs and SBTs. For TBTs, the most common reason for TT use was to prevent or reduce airway obstruction (72.3%, n = 34), followed closely by to prevent or reduce airway noise (55.3%, n = 16). Standardbred trainers assigned equal importance for TT use [to prevent or reduce airway obstruction (69.6%, n = 16) and to prevent the horse from moving its tongue over the bit (69.6%, n = 16)]. Tongue-ties were considered significantly less effective at improving performance than at reducing airway obstruction and preventing the tongue from moving over the bit (t = −2.700, p = 0.0007). For respondents who used both TTs and NBs, there was a mild to moderate positive association between the reasons for using TTs and NBs. Of the 70 TT-using respondents, 51.4% (n = 36) recorded having encountered either a physical or behavioural complication due to TT use, with redness/bruising of the tongue (20.0%, n = 14) being the most common physical complication reported. Duration of use influenced the risk of observing complications. The likelihood of a respondent reporting a behavioural complication due to TT use increased with every minute of reported application and a nine-minute increment in application period doubled the odds of a respondent reporting a complication. Tightness was a risk factor for physical complications: Checking TT tightness by noting the tongue as not moving was associated with increased reporting of physical complications (OR = 6.59; CI 1.1–67.5). This pilot study provides some insight into how and why TTs are applied by some racehorse trainers, and the potential risks associated with their use. A further study of a larger cohort is recommended because these results are valid for only the 112 trainers who responded and cannot be generalized to the equine industry.

scholarly journals Granzyme B Is a Biomarker for Suspicion of Malignant Seromas Around Breast Implants

2020 ◽  
Author(s):  
Marshall E Kadin ◽  
John Morgan ◽  
Haiying Xu ◽  
Caroline Glicksman ◽  
David Sieber ◽  
...  
Keyword(s):  
Early Detection ◽  
Tumor Cells ◽  
Breast Implant ◽  
Granzyme B ◽  
Breast Implants ◽  
Large Cell ◽  
Target Cells ◽  
Cytotoxic Lymphocytes ◽  
Tumor Cell Death ◽  
Level Of Evidence

Abstract Background Granzyme B (GrB) is a serine protease secreted, along with pore-forming perforin, by cytotoxic lymphocytes to mediate apoptosis in target cells. GrB has been detected in tumor cells associated with systemic and breast implant–associated anaplastic large cell lymphoma (BIA-ALCL) but its potential use for detection of early BIA-ALCL has not been fully investigated. Objectives Prompted by the increased incidence of BIA-ALCL, the aim of this study was to assess GrB as a new biomarker to detect early disease in malignant seromas and to better understand the nature of the neoplastic cell. Methods A Human XL Cytokine Discovery Magnetic Luminex 45-plex Fixed Panel Performance Assay was used to compare cytokine levels in cell culture supernatants of BIA-ALCL and other T-cell lymphomas, as well as malignant and benign seromas surrounding breast implants. Immunohistochemistry was employed to localize GrB to cells in seromas and capsular infiltrates. Results Differences in GrB concentrations between malignant and benign seromas were significant (P < 0.001). GrB was found in and around apoptotic tumor cells, suggesting that the protease may be involved in tumor cell death. Conclusions GrB is a useful marker for early detection of malignant seromas and to identify tumor cells in seromas and capsular infiltrates. Because there is an overlap between the lowest concentrations of soluble GrB in malignant seromas and the highest concentrations of GrB in benign seromas, it is recommended that GrB be used only as part of a panel of biomarkers for the screening and early detection of BIA-ALCL. Level of Evidence: 5

scholarly journals Pilot Study of Association of Bacteria on Breast Implants with Capsular Contracture

2009 ◽  
Vol 47 (5) ◽  
pp. 1333-1337 ◽  
Author(s):  
J. L. Del Pozo ◽  
N. V. Tran ◽  
P. M. Petty ◽  
C. H. Johnson ◽  
M. F. Walsh ◽  
...  
Keyword(s):  
Pilot Study ◽  
Capsular Contracture ◽  
Breast Implants

Water Resources Management

2014 ◽  
pp. 180-200 ◽  
Author(s):  
Sabyasachi Nayak
Keyword(s):  
Water Management ◽  
Pilot Study ◽  
Water Resources ◽  
Water Resources Management ◽  
Social Economic ◽  
The State ◽  
Resources Management ◽  
Partnership Approach ◽  
The Impact ◽  
Insight Into

This chapter explores grassroots interventions by forging partnerships with stakeholders in improving the management of water resources at the community level. In order to gain insight into the nuances of managing water resources in partnership, a pilot study was instituted in the State of Rajasthan, India. The efficacy of the partnership approach in ensuring equitable water management is demonstrated. The analysis is supported by data collected through the administration of a questionnaire for five different stakeholders. The impact of the intervention reiterates the positive social, economic, and environmental outcomes in a more sustainable manner.

Effect of Over the Counter Ibuprofen Dosing after Sinus Surgery for Chronic Rhinosinusitis: A Prospective Cohort Pilot Study

2020 ◽  
Vol 129 (7) ◽  
pp. 677-683
Author(s):  
Craig Miller ◽  
Ian M. Humphreys ◽  
Greg E. Davis
Keyword(s):  
Pilot Study ◽  
Prospective Cohort ◽  
Postoperative Bleeding ◽  
Bleeding Risk ◽  
Sinus Surgery ◽  
Level Of Evidence ◽  
Over The Counter ◽  
Bleeding Rate ◽  
Significant Difference ◽  
Opioid Medications

Introduction: Management of pain following endoscopic sinus surgery (ESS) often involves intermittent use of opioid medications. Given the current opioid crisis, many surgeons aim to minimize opioid prescriptions. However, surgeons often avoid the use of NSAIDs following ESS out of concern for increased bleeding risk. We sought to evaluate the effectiveness and safety of over the counter dosing of ibuprofen on pain and bleeding rates following ESS. Methods: Prospective cohort pilot study of patients undergoing ESS. Patients self-selected either control arm (acetaminophen and PRN oxycodone) or intervention arm (alternating ibuprofen with acetaminophen, and PRN oxycodone). Outcome measures included pain (10-point visual analog scale [VAS]), bleeding rate (10-point VAS), and number of opiate pills consumed. Results: Thirty-nine patients completed the study (15 control and 24 intervention). Overall, patients in the intervention arm reported decreased pain levels at days 1 (−0.9 [95%CI: −2.2, 0.5], 3 (−0.9 [95%CI: −2.3, 0.5]), and 7 (−0.6 [95%CI: −1.8, 0.6]), as well as decreased postoperative bleeding at those same days −0.9 [95%CI: −2.1, 0.4], −0.9 [95%CI: −2.1, 0.4], and −0.7 [95% CI: −1.2, −0.7], compared to controls. Opiate consumption was similar between groups with patients consuming on average four opiate pills (oxycodone 5 mg). Conclusions: Over the counter dosing of ibuprofen along with acetaminophen may yield better pain control after sinus surgery compared to acetaminophen alone. Additionally, there was no significant difference in epistaxis in the ibuprofen cohort compared to the cohort who did not take ibuprofen. Furthermore, this study showed very few opioid pills were consumed after routine ESS regardless of pain regimen prescribed. A larger trial is needed to make definitive statements on safety and efficacy. Level of Evidence: 2b

Breast Implant-Associated Anaplastic Large Cell Lymphoma in Australia: A Longitudinal Study of Implant and Other Related Risk Factors

2019 ◽  
Vol 40 (8) ◽  
pp. 838-846 ◽  
Author(s):  
Anna Loch-Wilkinson ◽  
Kenneth J Beath ◽  
Mark R Magnusson ◽  
Rodney Cooter ◽  
Karen Shaw ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Anaplastic Large Cell Lymphoma ◽  
Cell Lymphoma ◽  
Early Stage ◽  
Breast Implant ◽  
Breast Implants ◽  
Large Cell ◽  
Regulatory Action ◽  
Level Of Evidence ◽  
Large Cell Lymphoma

Abstract Background Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an emerging cancer that has been linked to the use of textured devices. The recent increase in number and frequency of cases has led to worldwide regulatory action. Objectives The authors aimed to longitudinally study BIA-ALCL in Australia since the index case was first reported in 2007. Methods Confirmed historical cases were collected and then prospectively analyzed from October 2015 to May 2019. Clinical and implant exposure data were determined and compared with company sales data for 4 devices to generate implant-specific risk. Results A total 104 cases of BIA-ALCL were diagnosed in Australia with exposure to 149 unique breast implants. The mean age of patients was 48.2 years (range, 22.4-78.5 years). They had an average time from implantation to diagnosis of 6.8 years. A total 51.7% of implants utilized in this cohort were Allergan Biocell devices. The indication for implant usage was for primary cosmetic augmentation in 70%, post-breast cancer reconstruction in 23%, and following weight loss/pregnancy in 7%. The majority of women presented with early (stage 1) disease (87.5%). The risk for developing BIA-ALCL ranged from 1 in 1947 sales (95% confidence interval = 1199-3406) for Silimed Polyurethane devices to 1 in 36,730 (95% confidence interval = 12,568-178,107) for Siltex imprinted textured devices. Conclusions Implants with higher surface area/texture seem to be more associated with BIA-ALCL in Australia. Recent regulatory action to suspend, cancel, or recall some of these higher risk devices is supported by these findings. Level of Evidence: 2

scholarly journals An evidence-based review of hyperbaric oxygen for children with cerebral palsy

2001 ◽  
Vol 57 (4) ◽  
pp. 21-22
Author(s):  
F. M. Bischof
Keyword(s):  
Cerebral Palsy ◽  
Pilot Study ◽  
Motor Function ◽  
Controlled Trial ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Children With Cerebral Palsy ◽  
High Level

This paper reviews the evidence in the literature for the use of hypebaric oxygen (HBO) in the treatment of cerebral palsy (CP). To date there are only two published studies on the outcome of HBO administration in CP. A pilot study showed significant improvement in gross motor function but provided a low level of evidence. A recent multicentre, double blind, placebo controlled trial reported similar improvements in both HBO and placebo groups, but no difference between the groups. This study had a high level of evidence. The results suggest that participation in the trial produced clinically important gains in function. The outcome of the study implies that HBO may have a placebo effect in CP.

Single Staged Mastopexy With Autologous Fat Grafting: An Alternative to Augmentation Mastopexy With Implants

2019 ◽  
Author(s):  
Jules Walters ◽  
Lynn Bourn ◽  
Oren Tessler ◽  
Charles Patterson ◽  
Kamran Khoobehi
Keyword(s):  
Surgical Site Infections ◽  
Breast Implants ◽  
Fat Grafting ◽  
Level Of Evidence ◽  
Breast Ptosis ◽  
Autologous Fat ◽  
Ptotic Breast ◽  
The Mean ◽  
To Receive ◽  
Augmentation Mastopexy

Abstract Background Improving the ptotic breast with mastopexy and restoring upper pole fullness with augmentation continues to be a challenging issue for plastic surgeons. Autologous fat grating (AFG) for shaping and contouring of implant augmented breasts has shown positive outcomes with few complications. Objectives The objective of this study was to evaluate our experience with combined mastopexy and fat grafting for women with existing breast ptosis who prefer not to receive prosthetic breast implants but do desire volume enhancement. Methods A retrospective review of patients undergoing a single staged mastopexy with AFG, from 2006 to 2017, was performed. Inclusion criteria were women with breast ptosis or tuberous breasts desiring improved breast shape and volume. Patients were excluded if they were undergoing implant removal before the procedure. Clinical aesthetic outcomes were assessed by fellow plastic surgeons according to the Telemark Breast Scoring system. Results A total of 284 breasts, in 140 women, underwent a single staged mastopexy with AFG. The mean amount of fat grafted per breast was 299.4 mL (range, 50-710 mL). There were no surgical site infections, hematomas, or seromas. There were 3 major and 8 minor (0.06%) postoperative breast complications. A total of 13 plastic surgeons, of the 183 invited (7.1%), completed the breast outcomes survey. Regarding each category, there was significant improvement (P ≤ 0.0001) in upper pole fullness, ptosis, overall aesthetics, and symmetry postoperatively. Conclusion AFG combined with mastopexy is not associated with significant postoperative complications and results in excellent breast aesthetic outcomes. Level of Evidence: 4

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