Smartphone-based thermography in flap surgery: A systematic review and meta-analysis of perforator identification.

Background: Thermography can be used in pre-operative planning of free perforator flap surgeries. Thermography assesses skin temperature by measuring the quantity of infrared radiation observed. In this meta-analysis, authors assess the sensitivity of smartphone-based thermal imaging (SBTI) in the detection of perforators and analyze the difference between static and dynamic imaging. Materials and methods: Authors followed the PRISMA guidelines for systematic reviews and meta-analyses. The meta package in R was used to conduct the meta-analysis. The "metaprop" function was used to calculate the overall sensitivity estimate and 95% confidence interval. The "metaprop.one" function was used to calculate subgroup estimates for static and dynamic study types. The "metareg" function was used to conduct meta-regression analyses to explore sources of heterogeneity. Results: This study includes seven articles with 1429 perforators being evaluated. The overall proportion of the sensitivities was estimated to be 0.8754 (95% CI: 0.7542; 0.9414) using a random effects model. The heterogeneity of the studies was high, as indicated by the tau^2 value of 1.2500 (95% CI: 0.4497; 8.4060) and the I^2 value of 92.6% (95% CI: 88.1%; 95.4%). The pooled sensitivity for static imaging was 0.8636 (95%CI: 0.6238-0.9603) with a tau^2 of 2.0661 and a tau of 1.4374, while the pooled sensitivity for dynamic imaging was slightly higher (p = 0.7016) at 0.8993 (95%CI: 0.7412-0.9653) with a smaller tau^2 of 0.8403 and a tau of 0.9167. Conclusion: Further studies need to confirm that SBTI is a reliable and convenient technique for detecting perforators for the pre-operative planning of free perforator flap surgeries.

[Coronary anaphylaxis or Kounis syndrome]. / Anaphylaxie coronaire ou syndrome de Kounis.

Although not well known, Kounis syndrome represents 3.4 % of anaphylactic reactions and has a high level of mortality (7 %). Its main clinical presentation looks like an acute coronary syndrome. We report the case of a 61-year old patient who was admitted in the emergency department because of a malaise with loss of consciousness due to a Kounis syndrome that occurred after the ingestion of amoxycilline.

Le syndrome de Kounis représente une entité mal connue, bien que présent dans 3,4 % des réactions anaphylactiques avec une mortalité élevée de 7 %. Ses manifestations sont des symptômes mimant un syndrome coronarien aigu. Nous présentons ici le cas d'un patient de 61 ans admis au service des urgences pour un malaise avec perte de connaissance attribué à un syndrome de Kounis survenu dans les suites de la prise d'amoxycilline.

Abdominoplasty and lower body lift surgery improves the quality of life after massive weight loss: a prospective multicenter study.

BACKGROUND: This study was conducted to assess the impact of abdominoplasty and lower body lift surgery following massive weight loss on both the general quality of life and the sexual life of patients. METHODS: We performed a multicenter prospective study on the quality of life after massive weight loss using three scoring questionnaires: The Short Form 36 questionnaire, the Female Sexual Function Index questionnaire, and the Moorehead-Ardelt Quality of Life Questionnaire. Seventy-two patients who underwent lower body lift and 57 patients who underwent abdominoplasty in three centers with pre and post-operative evaluation were included. RESULTS: The mean age of the patients was 43.2 ± 13.2 years. All categories of the SF36 questionnaire were statistically significant at 6 months, and all categories except health change were significantly improved at 12 months post-operative. Overall, the Moorehead-Ardelt questionnaire showed a higher quality of life in general (1.78 ± 0.92 and 1.64 ± 1.03, at 6 and 12 months respectively) and in all domains (self-esteem, physical activity, social relationships, work performance, and sexual activity). Interestingly, global sexual activity improved at 6 months but not at 12 months. Some domains of sexual life improved at 6 months (desire, arousal, lubrication, satisfaction), but only the desire stayed improved at 12 months. CONCLUSION: Abdominoplasty and lower body lift improve the quality of life of patients after massive weight loss as well as the sexual quality of life. This should be an additional valid reason for promoting reconstructive surgery for massive weight loss patients.