scholarly journals Augmentation mastopexy after bariatric surgery: evaluation of patient satisfaction and surgical results.

2016 ◽  
Vol 43 (3) ◽  
pp. 160-164 ◽  
Author(s):  
WILSON CINTRA JUNIOR ◽  
MIGUEL LUIZ ANTONIO MODOLIN ◽  
RODRIGO ITOCAZO ROCHA ◽  
ROLF GEMPERLI
Keyword(s):  
Patient Satisfaction ◽  
Breast Implant ◽  
Surgical Results ◽  
Areolar Complex ◽  
Photographic Analysis ◽  
Scar Quality ◽  
The Mean ◽  
A Prospective Study ◽  
Inclusion Methods ◽  
Augmentation Mastopexy

ABSTRACT Objective: to evaluate patient satisfaction and surgical results obtained after mastopexy with breast implant inclusion. Methods: we conducted a prospective study of 20 consecutive female patients with a mean age of 39.9 years, submitted to augmentation mastopexy. We applied semi-directed psychological interviews pre and postoperatively. The answers to the evaluations were tabulated, categorized, and allowed patient satisfaction analysis. We evaluated surgical results through photographic analysis of three independent plastic surgeons, in the pre and postoperative periods, when scores were attributed to the following items: breasts shape, breasts volume, breasts symmetry, nipple-areolar complex position, and scar quality and extent. Results: nineteen patients (95%) referred satisfaction with the surgical results attained (p<0,001). The mean sum of the scores attributed by the three surgeons to each patient varied between 4.7 and 10, with an overall mean of 7.28. The results were considered good or great for 65% of the sample and poor for 8.4%. Conclusion: there was a 95% satisfaction rate among patients with the results obtained through augmentation mastopexy. The photographic analysis of the results obtained a mean score of 7.28, considered as a good result, albeit the weak correlation among evaluators.

scholarly journals Distraction Lengthening of First Metacarpal in Traumatic Thumb Amputations

2019 ◽  
Vol 52 (03) ◽  
pp. 309-313
Author(s):  
Abid Saleem ◽  
Ramesh Kumar Sharma ◽  
Parmod Kumar
Keyword(s):  
Patient Satisfaction ◽  
Total Duration ◽  
Pinch Strength ◽  
Thumb Reconstruction ◽  
Duration Of Treatment ◽  
Process Duration ◽  
Advantages And Disadvantages ◽  
Common Etiology ◽  
The Mean ◽  
A Prospective Study

Abstract Introduction Based on the level of the thumb loss, phalangization, toe-to-thumb transfer, pollicization, and distraction callotasis of the first metacarpal are the various options available for reconstruction. The aims of the study were to observe the length gained in the distraction process, duration of treatment required, functional recovery in the form of pinch strength, sensations, and patient satisfaction. Patients and Methods It was a prospective study of 10 patients of thumb amputation, conducted from January 2014 to July 2015. The patients’ age, mode of injury, level of amputation, and advantages and disadvantages of distraction callotasis were evaluated. Results The most common etiology of thumb loss was domestic accidents while working with a chaff cutter. The total duration of treatment was 124 (93–165) days and the mean gain in length was 25 (20–28) mm. The pinch strength increased from a mean of 0.91 to 2.06 kg, i.e., a 44.17% improvement from preoperative pinch strength. All of our patients retained their sensations of the reconstructed thumb post distraction. Conclusions Among many options for thumb reconstruction, distraction callotasis is a simple and safer option in the selective group of patients who are not keen on toe-to-thumb transfer which provide a significant improvement. The longer duration of treatment is the disadvantage associated with the need for proper counselling beforehand.

A Durometer (Mammometer) for Objective Measurement Capsular Contraction Following Breast Implant Surgery

2020 ◽  
Vol 37 (4) ◽  
pp. 189-194 ◽  
Author(s):  
Tracey Murphy ◽  
Stephen Brown ◽  
Tim Brown
Keyword(s):  
Breast Augmentation ◽  
Breast Implant ◽  
Normal Breast ◽  
Contralateral Breast ◽  
Corrective Surgery ◽  
Capsular Contraction ◽  
Nipple Areolar Complex ◽  
Areolar Complex ◽  
Mean Pressure ◽  
The Mean

The importance of measuring breast firmness reproducibly to monitor postsurgical progress has been appreciated for many years. This study ascertains whether a durometer can be used to quantify capsular contraction and to provide an objective, reproducible measure of fibrosis around an implant. Patients with clinically detected Baker 3 or 4 capsules following breast augmentation underwent firmness measurements using a durometer prior to corrective surgery. Durometry was undertaken on both breasts by an operator who was blinded to the clinical diagnosis. Firmness measurements were taken in each breast quadrant and directly over the nipple-areolar complex on each side. In the study, 16 patients were included. Capsules presented 16 to 714 weeks following surgery (mean 217, standard deviation (STD) 205.4 weeks). Differences in pressure were demonstrated in all quadrants of the breast and at the nipple-areolar complex except the lower inner quadrant. All significant differences demonstrated a higher pressure in the encapsulated breast. The mean pressure in an encapsulated breast was 0.66 kPa (STD 0.25) and 0.46 kPa (STD 0.16) in the normal breast. The durometer can reproducibly describe changes in pressure associated with capsular contraction compared with the contralateral breast. It provides a means of objectively describing capsular contraction following breast augmentation surgery for research and patient care.

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

Osteotomy for Correction of Premature Growth Plate Closure in 24 Dogs

1994 ◽  
Vol 07 (03) ◽  
pp. 129-135 ◽  
Author(s):  
C.W. Miller ◽  
P.W. Morgan
Keyword(s):  
Corrective Osteotomy ◽  
Functional Results ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Angular Deformity ◽  
Dynamic Correction ◽  
Age At Surgery ◽  
Limb Deformities ◽  
The Mean ◽  
A Prospective Study

SummaryTwenty-four dogs (27 limbs) were evaluated after surgery for correction of forelimb angular limb deformities. Partial ulnar ostectomies or definitive corrective osteotomies were performed depending upon the age of the dog. According to owner assessment nine of fourteen limbs were considered functionally good, or excellent, after partial ulnar ostectomies. Younger dogs appeared to have better functional results after dynamic correction with the mean age at surgery of dogs with good to excellent results being 6.5 months contrasted to the mean age at surgery of dogs with fair to poor results being 9.75 months. Ten of fourteen limbs were considered functionally good or excellent after definitive corrective osteotomy. One dog had definitive osteotomy after partial ulnar ostectomy in order to further correct a residual angular deformity. However, 58% of the limbs with radiographic follow-up had signs of degenerative joint disease (DJD). There were not significant differences between neither degree of angulation remaining after surgery and the functional result nor the degree of angulation remaining after surgery and the development of DJD. A prospective study is warranted to more objectively assess the efficacy of surgical correction of angular limb deformities in dogs.Twenty-four dogs were evaluated after surgery for correction of forelimb angular limb deformities. The results are described.

scholarly journals Sulcus-Deepening Trochleoplasty for Trochlear Dysplasia

2021 ◽  
Vol 1 (3) ◽  
pp. 263502542110111
Author(s):  
Anthony J. Ignozzi ◽  
Zane Hyde ◽  
Scott E. Dart ◽  
David R. Diduch
Keyword(s):  
Patient Satisfaction ◽  
Trochlear Dysplasia ◽  
Recurrent Dislocation ◽  
Trochlear Groove ◽  
Thick Shell ◽  
Absorbable Sutures ◽  
Postoperative Dislocation ◽  
A Prospective Study ◽  
Patellar Stability

Background: Patients who are refractory to initial management of trochlear dysplasia, which consists of bracing and physical therapy, may be candidates for trochleoplasty. Indications: Indications for trochleoplasty include Dejour classification type B or D trochlear dysplasia, supratrochlear spur height ≥7 mm, and a positive J sign on examination. Technique Description: The thick shell sulcus-deepening trochleoplasty technique involves removing the supratrochlear spur by creating a 5-mm–thick osteochondral shell with underlying cavity, dividing the thick shell into medial and lateral leaflets, and securing the leaflets with absorbable sutures. This establishes a new trochlear groove that is flush with the anterior cortex of the femur. Results: A review of 21 studies with length of follow-up from 8.8 months to 15 years found postoperative dislocation was present in 0% to 15% of patients and the patient satisfaction ranged from 81.0% to 94.4%. A prospective study with a minimum 2-year follow-up found no cases of recurrent dislocation, no progression of radiographic arthritis, 84.8% of patients returned to sport, and the patient satisfaction was a 9.1/10. Discussion/Conclusion: Sulcus-deepening trochleoplasty for trochlear dysplasia provides patellar stability and excellent patient satisfaction.

Usefulness of point-of-care ultrasound in military medical emergencies performed by young military medicine residents

2019 ◽  
pp. jramc-2018-001132
Author(s):  
Pierre Perrier ◽  
J Leyral ◽  
O Thabouillot ◽  
D Papeix ◽  
G Comat ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Clinical Examination ◽  
Point Of Care ◽  
Military Medicine ◽  
Final Diagnosis ◽  
Absolute Difference ◽  
Point Of Care Ultrasound ◽  
Medical Emergencies ◽  
The Mean ◽  
A Prospective Study

IntroductionTo evaluate the usefulness of point-of-care ultrasound (POCUS) performed by young military medicine residents after short training in the diagnosis of medical emergencies.MethodsA prospective study was performed in the emergency department of a French army teaching hospital. Two young military medicine residents received ultrasound training focused on gall bladder, kidneys and lower limb veins. After clinical examination, they assigned a ‘clinicaldiagnostic probability’ (CP) on a visual analogue scale from 0 (definitely not diagnosis) to 10 (definitive diagnosis). The same student performed ultrasound examination and assigned an ‘ultrasounddiagnostic probability’ (UP) in the same way. The absolute difference between CP and UP was calculated. This result corresponded to the Ultrasound Diagnostic Index (UDI), which was positive if UP was closer to the final diagnosis than CP (POCUS improved the diagnostic accuracy), and negative conversely (POCUS decreased the diagnostic accuracy).ResultsForty-eight patients were included and 48 ultrasound examinations were performed. The present pathologies were found in 14 patients (29%). The mean UDI value was +3 (0–5). UDI was positive in 35 exams (73%), zero in 12 exams (25%) and negative in only one exam (2%).ConclusionPOCUS performed after clinical examination increases the diagnostic accuracy of young military medicine residents.

scholarly journals Biological and clinical impact of hemangioblastoma-associated peritumoral cysts in von Hippel-Lindau disease

2016 ◽  
Vol 124 (4) ◽  
pp. 971-976 ◽  
Author(s):  
Kristin Huntoon ◽  
Tianxia Wu ◽  
J. Bradley Elder ◽  
John A. Butman ◽  
Emily Y. Chew ◽  
...  
Keyword(s):  
Clinical Impact ◽  
Anatomical Location ◽  
Von Hippel Lindau ◽  
Study Enrollment ◽  
Common Location ◽  
Younger Age ◽  
The Mean ◽  
A Prospective Study ◽  
Vhl Disease

OBJECT Peritumoral cysts are frequently associated with CNS hemangioblastomas and often underlie neurological morbidity and mortality. To determine their natural history and clinical impact, the authors prospectively analyzed hemangioblastoma-associated peritumoral cysts in patients with von Hippel-Lindau (VHL) disease. METHODS Patients with VHL disease who had 2 or more years of follow-up and who were enrolled in a prospective study at the National Institutes of Health were included. Serial prospectively acquired laboratory, genetic, imaging, and clinical data were analyzed. RESULTS One hundred thirty-two patients (of 225 in the VHL study with at least 2 years of follow-up) had peritumoral cysts that were followed for more than 2 years (total of 292 CNS peritumoral cysts). The mean age at study entrance was 37.4 ± 13.1 years ([mean ± SD], median 37.9, range 12.3–65.1 years). The mean follow-up was 7.0 ± 1.7 years (median 7.3, range 2.1–9.0 years). Over the study period, 121 of the 292 peritumoral cysts (41.4%) became symptomatic. Development of new cysts was associated with a larger number cysts at study enrollment (p = 0.002) and younger age (p < 0.0001). Cyst growth rate was associated with anatomical location (cerebellum cysts grew faster than spine and brainstem cysts; p = 0.0002 and p = 0.0008), younger age (< 35 years of age; p = 0.0006), and development of new neurological symptoms (p < 0.0001). Cyst size at symptom production depended on anatomical location (p < 0.0001; largest to smallest were found, successively, in the cerebellum, spinal cord, and brainstem). The most common location for peritumoral cysts was the cerebellum (184 cysts [63%]; p < 0.0001). CONCLUSIONS Peritumoral cysts frequently underlie symptom formation that requires surgical intervention in patients with VHL disease. Development of new cysts was associated with a larger number of cysts at study enrollment and younger age. Total peritumoral cyst burden was associated with germline partial deletion of the VHL gene.

Are ultrasonography measurements of optic nerve sheath diameter an alternative to funduscopy in children with syndromic craniosynostosis?

2011 ◽  
Vol 8 (3) ◽  
pp. 329-334 ◽  
Author(s):  
Caroline Driessen ◽  
Natalja Bannink ◽  
Maarten Lequin ◽  
Marie-Lise C. van Veelen ◽  
Nicole C. Naus ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Predictive Values ◽  
Syndromic Craniosynostosis ◽  
Nerve Sheath ◽  
Age Related ◽  
The Mean ◽  
A Prospective Study ◽  
Ct Measurement

Object Children with syndromic or complex craniosynostosis are evaluated for increased intracranial pressure (ICP) using funduscopy to detect papilledema. However, papilledema is a late sign of increased ICP. Because papilledema might be preceded by an increase in optic nerve sheath (ONS) diameter, the authors conducted a prospective study to establish the validity and applicability of measuring the ONS using ultrasonography. Methods From January 2007 to December 2009, 175 bilateral ultrasonography ONS measurements were performed in 128 patients with syndromic or complex craniosynostosis during the daytime. The measurements were correlated with ONS diameter assessed on CT and simultaneous funduscopy, when available. Furthermore, results were compared by using thresholds for ONS diameters on ultrasonography that are available in the literature. Results The mean ONS diameter on ultrasonography was 3.1 ± 0.5 mm. The CT measurement was significantly correlated with the ultrasonography measurement (r = 0.41, p < 0.001). The mean ONS diameter in 38 eyes with papilledema was 3.3 ± 0.5 mm, compared with 3.1 ± 0.5 mm in the eyes of patients without papilledema (p = 0.039). Relative to the age-related thresholds, the ONS diameter was too large in 11 eyes (3%), particularly in patients with Crouzon syndrome. Compared with funduscopy, ultrasonography sensitivity was 11%, specificity was 97%, and positive and negative predictive values were 40% and 86%, respectively. Conclusions Ultrasonography is a valid and easy way of quantifying the ONS. Although the ONS diameter is larger in children with papilledema, it cannot be used as a daytime screening tool instead of funduscopy. The ONS diameter is possibly a more real-time indicator of ICP.

The Impact of Medical Comorbidities on Patient Satisfaction in Chronic Rhinosinusitis

2021 ◽  
pp. 000348942110157
Author(s):  
Amarbir S. Gill ◽  
Joshua Hwang ◽  
Angela M. Beliveau ◽  
Jeremiah A. Alt ◽  
Edward Bradley Strong ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Hearing Impairment ◽  
Chronic Rhinosinusitis ◽  
Medical Comorbidities ◽  
Patient Demographics ◽  
Significant Difference ◽  
Comorbidity Index ◽  
The Mean ◽  
Therapy Compliance ◽  
The Impact

Background: Patient satisfaction has a significant bearing on medical therapy compliance and patient outcomes. The purpose of this study was to (1) describe patient satisfaction, as characterized by the Patient Satisfaction Questionnaire-18 (PSQ-18), in the care of patients with chronic rhinosinusitis (CRS) and (2) analyze the impact of comorbidities on satisfaction using the functional comorbidity index (FCI). Methods: Patient demographics, disease severity measures, and PSQ-18 scores for patients with CRS presenting to a tertiary rhinology clinic between November 2019 and April 2020 were collected and analyzed. FCI was calculated retrospectively using the electronic medical record; individual comorbidities were tabulated. Spearman’s correlations followed by multivariate regression was used to assess the relationship between medical comorbidities and PSQ-18. Results: Sixty-nine patients met criteria for analysis. There were no significant differences in age, gender, and Sinonasal Outcomes Test-22 scores between CRS patients with (CRSwNP) and without (CRSsNP) nasal polyps. There was no significant difference in the mean FCI for patients with CRSwNP versus CRSsNP (5.1 and 4.3, respectively) ( P = .843). Similarly, there was no significant difference in the mean sum PSQ-18 score (78/100 in both) between these cohorts ( P = .148). The mean sum PSQ-18 score was not significantly associated with anxiety ( P = .728), depression ( P = .624), or FCI ( P = .282), but was significantly associated with hearing impairment ( P < .001). Conclusion: Patient satisfaction in the care of CRS is generally high with a diagnosis of comorbid hearing impairment demonstrating a negative association with satisfaction in this cohort.

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