The fascial structure of the breast: New findings on the anatomy of the inframammary fold

xlomafota13 shared this article with you from Inoreader The fascial structure of the breast: New findings on the anatomy of the inframammary fold Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Dec 7:S1748-6815(21)00647-1. doi: 10.1016/j.bjps.2021.11.109. Online ahead of print. ABSTRACT The inframammary fold defines the shape and structure of the breast, especially in women. As the inframammary fold is placed between the fifth and sixth ribs, the ligaments or fascia are thought to attach from these ribs. However, the previous literature on what structures constitute the inframammary fold does not provide sufficient knowledge for reconstructing the natural form of the fold. This study aimed to clarify the structure that involves the inframammary fold. Ten sides of five formalin-fixed, adult Asian cadaveric breasts were studied. Upon dissection of the breast, including the ribs, the fat lobules were removed while preserving the septal structures under the microscope. The fascial structures were observed grossly and radiographically. A multilayered fascial structure was noted from the dermis n ear the inframammary fold, anchored to the deep fascia of the pectoralis major muscle mainly at the height of the fourth rib and partially of the fifth rib, from the outside of the nipple to the linea axillaris media, where the fold could be clearly observed. Additionally, the fat lobules around the inframammary fold were subdivided by thin septa closer to the dermis, and they fused posteriorly and upward to form this fascial structure. The inframammary fold was not formed by an adhesion directly under the sixth rib, but by the skin "hanging" from the height of the fourth and fifth ribs due to the multilayered fascial structure that repeatedly fused and dissociated and the changes in the size of the fat lobules. This new anatomical finding may help in inframammary fold reconstruction. PMID:34998682 | DOI:10.1016/j.bjps.2021.11.109 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

New drug approval: Pembrolizumab in association with chemotherapy as first line treatment for advanced/metastatic oesophageal carcinomas or HERnegative gastroesophageal adenocarcinoma, expressing PD-L1 with a CPS≥10

xlomafota13 shared this article with you from Inoreader New drug approval: Pembrolizumab in association with chemotherapy as first line treatment for advanced/metastatic oesophageal carcinomas or HERnegative gastroesophageal adenocarcinoma, expressing PD-L1 with a CPS≥10 Via Association française pour l'étude du cancer Bull Cancer. 2022 Jan 5:S0007-4551(21)00575-0. doi: 10.1016/j.bulcan.2021.09.021. Online ahead of print. NO ABSTRACT PMID:34998526 | DOI:10.1016/j.bulcan.2021.09.021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cerebrospinal fluid leak repair: utility of intrathecal fluorescein for correct topographic identification of the skull base defects

xlomafota13 shared this article with you from Inoreader Cerebrospinal fluid leak repair: utility of intrathecal fluorescein for correct topographic identification of the skull base defects Via leak of cerebrospinal fluid World Neurosurg. 2022 Jan 6:S1878-8750(22)00007-9. doi: 10.1016/j.wneu.2022.01.004. Online ahead of print. ABSTRACT BACKGROUND: In the management of cerebrospinal fluid (CSF) leak the identification of the exact discharge spot is paramount. This can represent a challenge for the radiologist and the surgeon. In the present study, we analyzed a series of patients affected by endonasal CSF leak who underwent endoscopic surgical reconstruction aided by the use of intrathecal fluorescein (ITF). The purpose of this work is to assess the efficacy of intraoperative ITF in addition to computed tomography (CT) scan and magnetic resonance imaging (MRI) for correct topographic localization of the CSF leak. METHODS: Eighty-three patients were enrolled in the study. The main outcome was the concordance between the supposed radiological defect site and the actual one seen intraoperatively. The recurrence free survival (RFS) was evaluated as secondary outcome. RESULTS: ITF better defined the defect site allowing a change in the treatment in 21 cases (25.3%), in which a non-concordance was observed between the suspected radiological site and the actual surgical one. Good agreement was found between the specific topographic localization (k=0.737, p<0.0001), whereas fair agreement was observed considering the side of the defect (k=0.362, p=0.0009) and correct identification of multiple sites (k=0.044, p=0.666). The 10-year 96% estimate of RFS confirmed the correct repair of the fistula site in most of the cases. CONCLUSIONS: Our data demonstrate the utility and safety of intraoperative ITF for management of patients affected by endonasal CSF leak. ITF improved the topographical diagnosis of the leak site, ensuring the best target reconstruction and very low recurrence rate. PMID:34999266 | DOI:10.1016/j.wneu.2022.01.004 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Modifying Ways to Perform ICU Tracheostomies

xlomafota13 shared this article with you from Inoreader Modifying Ways to Perform ICU Tracheostomies in COVID-19 Patients: Approach to a Safe and Secure Method Via Otolaryngology Indian Abstract Background This study outlines the unique modifications to surgical tracheostomy procedure to combat the extraordinary situation the world has found itself in due to COVID 19 pandemic. We explain the modifications employed to the operative setup, anesthetic considerations and surgical procedure to enable us to provide timely and safe tracheostomy to the COVID ICU patients requiring it, while simultaneously maximally protecting our surgical personnel from the deadly exposure. Methods- We conducted 55 surgical tracheostomies in severely sick ICU patients with the modifications deemed fit to achieve safe procedure for both the patient and the operating team. We analyzed the hospital record data of these patients and the surgical teams COVID 19 status to assesss the efficacy of our procedural modifications. Discussion- The COVID 19 pandemic has thrown the entire medical fraternity into a dilemma as to how to provide the best possible care to the patients while protecting ourselves from its grip. Severely sick COVID patients often require tracheostomy for improved prognosis. We performed bedside open surgical tracheostomy and induced transient apnoea periprocedur along with carinal intubation. By making these simple and cost effective modifications to the procedure, we have ensured that patients get tracheostomised as and when required but not at the cost of the health and lives of our health care workers. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Trend of Allergic Rhinitis

xlomafota13 shared this article with you from Inoreader Trend of Allergic Rhinitis Post COVID-19 Pandemic: A Retrospective Observational Study Via Otolaryngology Indian Abstract To study, compare and analyse the trend of allergic rhinitis incidence post COVID-19 pandemic in a tertiary care hospital in Patna Bihar. This is a retrospective observational study done at Patna medical college from January to June 2020. The number of patients with signs and symptoms of allergic rhinitis post pandemic (March–July2020) were compared to preceding three months (Jan 2020–March2020). Chi square test was employed to know and infer whether the change in trend of incidence is statistically significant. There is decrease in trend of allergic rhinitis in our study at our centre. P < .01. Decrease in pollution due to lockdown and increased use of mask and increase indoor activities may be the reason for decreasing trend of allergic rhinitis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Epidemiology, Clinical Features and Management of Rhino Orbital Mucormycosis in Post COVID 19 Patients

xlomafota13 shared this article with you from Inoreader Epidemiology, Clinical Features and Management of Rhino Orbital Mucormycosis in Post COVID 19 Patients Via Otolaryngology Indian Abstract COVID 19 infections may be associated with a wide range of bacterial and fungal co-infections. Mucormycosis is a fungal infection primarily affecting immunocompromised individuals. We have observed sudden rise of mucormycosis cases in post COVID 19 patients. Here we have reported 100 cases of mucormycosis associated with COVID 19. To study epidemiology and clinical features of rhino orbital mucormycosis in post COVID 19 patients. To evaluate efficacy of medical as well as surgical treatment in such patients. This was an observational mixed (retrospective + prospective) study with a duration of 2 months. After noting demographic data, necessary radiological investigation was advised and representative tissue was sent for KOH and histopathological examination. Medical and surgical treatment was planned accordingly. Most patients (55%) presented with complaint of headache and facial pain. Hard palate involvement was observed in 45% patients. Unilateral pr esentation (68%) was more common. Only 25% patients who presented early had normal vision. We reported 22 patients with complete loss of vision. Eye movements were restricted in 58% patients. Diabetes mellitus is most common predisposing factor (65%). 9 patients required orbital exentration. Only 18% patients required Amphotericin for more than 14 days. Immune dysregulation caused by COVID 19 infection in addition to widespread use of steroids and broad-spectrum antibiotics may lead to the development mucormycosis. Diabetes Mellitus type II is another important risk factor and the presence of both have additional effect in causing mucormycosis. Headache and facial pain should be considered highly suspicious of mucormycosis. Early diagnosis with efficient treatment can improve prognosis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Treatment of Uveal Melanoma With Radioactive Iodine 125 Implant Compared With Proton Beam Radiotherapy

xlomafota13 shared this article with you from Inoreader Treatment of Uveal Melanoma With Radioactive Iodine 125 Implant Compared With Proton Beam Radiotherapy Via radioactive iodine Mayo Clin Proc Innov Qual Outcomes. 2021 Dec 22;6(1):27-36. doi: 10.1016/j.mayocpiqo.2021.10.002. eCollection 2022 Feb. ABSTRACT OBJECTIVE: To review the current state of radiation therapy for uveal melanoma and compare particle radiation and brachytherapy. PATIENTS AND METHODS: The medical records of 156 patients treated for uveal melanoma between May 30, 2012, and March 16, 2020, were retrospectively reviewed. Treatments consisted of either radioactive iodine 125 implant (R AI) or fractionated proton radiation (proton beam therapy [PBT]). Baseline characteristics were compared using a Wilcoxon rank sum test or χ2 test. Outcomes were compared using Cox proportional hazards regression models or logistic regression models. RESULTS: The median length of follow-up after treatment was 2.7 years (range, 0.5 to 9.0 years). Patients who underwent treatment with RAI were older (median age, 67 vs 59 years; P<.001) and had a lower tumor classification (American Joint Commission on Cancer; P=.001) compared with those who underwent PBT. There was no significant difference between RAI and PBT in the outcomes of liver metastases, death, enucleation, tearing, vision loss, retinal detachment, tumor thickness, conjunctivitis, optic neuropathy, iris neovascularization, or neovascular glaucoma (all P>.05). Patients who underwent RAI treatment had significantly higher risk of diplopia (P<.001), cataract progression (P<.001), and m aculopathy (P=.03) compared with those who received PBT. Patients who underwent RAI were at higher risk of eyelash loss (P=.006) compared with the PBT group. CONCLUSION: Treatment with PBT and RAI has similar efficacy; however, there are differences in the adverse outcomes associated with these 2 modalities. PMID:35005435 | PMC:PMC8715138 | DOI:10.1016 /j.mayocpiqo.2021.10.002 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The effect of peritonsillar infiltration of tramadol vs dexmedetomidine on post‑tonsillectomy pain

xlomafota13 shared this article with you from Inoreader The effect of peritonsillar infiltration of tramadol vs dexmedetomidine on post‑tonsillectomy pain Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2022 Jan 10. doi: 10.1007/s00405-021-07212-7. Online ahead of print. NO ABSTRACT PMID:35001165 | DOI:10.1007/s00405-021-07212-7 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Brain Herniation Secondary to Cerebrospinal Fluid Leak Following Elective Lumbar Spine Surgery

xlomafota13 shared this article with you from Inoreader Brain Herniation Secondary to Cerebrospinal Fluid Leak Following Elective Lumbar Spine Surgery Via leak of cerebrospinal fluid Cureus. 2021 Dec 8;13(12):e20266. doi: 10.7759/cureus.20266. eCollection 2021 Dec. ABSTRACT Lumbar spine surgery can be complicated by perioperative cerebrospinal fluid (CSF) leak. However, development of brain herniation secondary to CSF leak following lumbar spine surgery has not been previously reported in the current literature. This case report describes a 48-year-old woman who, after a revision lumbar decompression and fusion, experienced CSF leak followed by development of brain herniation, which resulted in patient demise. The postoperative period was complicated by patient nonadherence to conservative management of CSF leak. PMID:35004068 | PMC:PMC8735843 | DOI:10.7759/cureus.20266 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical Treatment of Acquired Velopharyngeal Insufficiency in Adults With Dysphagia and Dysphonia

xlomafota13 shared this article with you from Inoreader Surgical Treatment of Acquired Velopharyngeal Insufficiency in Adults With Dysphagia and Dysphonia Via Journal of Voice Velopharyngeal insufficiency (VPI) is a form of velopharyngeal dysfunction caused by abnormal or insufficient anatomy. This process is known to be associated with dysphagia and dysphonia but surgical interventions for these complex patients have not been well studied. The current study characterized a small cohort of adult patients with acquired VPI, dysphonia, and dysphagia, as well as associated surgical interventions. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Fibroangiolipoma of palatine tonsil: A case report and literature review

xlomafota13 shared this article with you from Inoreader Fibroangiolipoma of palatine tonsil: A case report and literature review Via ear nose throat Ear Nose Throat J. 2022 Jan 10:1455613211072587. doi: 10.1177/01455613211072587. Online ahead of print. ABSTRACT Lipomas of the palatine tonsil are rare benign neoplasms in clinical practice. We present a case of palatine tonsillar fibroangiolipoma in a 50-year-old Chinese male with a history of multiple lipomas on the back and extremities. It was diagnosed based on histological examination and integrated analysis. Good wound healing and no evidence of recurrence were noted within 6 months follow-up after tonsillectomy. This article also puts a spotlight on the differential diagnosis of benign tonsillar tumors and reviewed recent relevant literature. PMID:35006014 | DOI:10.1177/01455613211072587 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

What's in a Name? A Cost-Effectiveness Analysis of the Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features' Nomenclature Revision

xlomafota13 shared this article with you from Inoreader What's in a Name? A Cost-Effectiveness Analysis of the Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features' Nomenclature Revision Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.