Impact of autologous breast reconstruction on bra fit.

PURPOSE: To inform bra design by analyzing 3D surface images of breast cancer patients who underwent autologous breast reconstruction. METHODS: We computed bra design measurements on 3D surface images of patients who underwent unilateral and bilateral autologous breast reconstruction. Breast measurements and right-left symmetry between preoperative baseline and postoperative time points were compared using either paired Student t-test or Wilcoxon signed-rank test, depending on the data's distribution. Regression analysis determined associations between measurements and patient characteristics such as age. Postoperative measurements and symmetry differences were also compared between autologous and implant-based breast reconstruction. RESULTS: Among participants who underwent bilateral autologous breast reconstruction, the reconstructed breasts were smaller and positioned higher on the chest wall than their native breasts. For patients who underwent unilateral reconstruction, similar postoperative changes were observed in the contralateral breast due to symmetry procedures. Overall, for participants whose baseline breast measurements showed substantial asymmetry, unilateral reconstruction decreased right-left asymmetry whereas bilateral reconstruction amplified right-left asymmetry. Preoperative baseline breast measurements, age, and BMI were statistically significantly associated with most postoperative breast measurements for participants who underwent bilateral autologous reconstruction. Compared to implant-based reconstruction, autologous reconstruction resulted in fewer changes in breast shape and symmetry that are pertinent to bra fit. CONCLUSION: Preoperative baseline breast measurements, age, and BMI can impact bra designs for breast cancer survivors who undergo autologous reconstruction due to size, shape, and symmetry changes. Bra needs of people who undergo autologous reconstruction differ from those who undergo implant-based reconstruction.

Impact of Autologous Breast Reconstruction on Bra Fit.

Purpose: To inform bra design by analyzing 3D surface images of breast cancer patients who underwent autologous breast reconstruction. Methods: We computed bra design measurements on 3D surface images of patients who underwent unilateral and bilateral autologous breast reconstruction. Breast measurements and right-left symmetry between preoperative baseline and postoperative time points were compared using either paired Student t test or Wilcoxon signed rank test, depending on the data's distribution. Regression analysis determined associations between measurements and patient characteristics such as age. Postoperative measurements and symmetry differences were also compared between autologous and implant-based breast reconstruction. Results: Among participants who underwent bilateral autologous breast reconstruction, the reconstructed breasts were smaller and positioned higher on the chest wall than their native breasts. For patients who underwent unilateral reconstruction, similar postoperative changes were observed in the contralateral breast due to symmetry procedures. Overall, for participants whose baseline breast measurements showed substantial asymmetry, unilateral reconstruction decreased right-left asymmetry whereas bilateral reconstruction amplified right-left asymmetry. Preoperative baseline breast measurements, age, and BMI were statistically significantly associated with most postoperative breast measurements for participants who underwent bilateral autologous reconstruction. Compared to implant-based reconstruction, autologous reconstruction resulted in fewer changes in breast shape and symmetry that are pertinent to bra fit. Conclusion: Preoperative baseline breast measurements, age, and BMI can impact bra designs for breast cancer survivors who undergo autologous reconstruction due to size, shape, and symmetry changes. Bra needs of people who undergo autologous reconstruction differ from those who undergo implant-based reconstruction.

Impact of implant-based breast reconstruction on bra fit.

Comfortable and well-fitting bras are necessary for good quality of life but hard to find for women who undergo reconstruction after breast cancer treatment. This study aimed to provide data to inform bra designs for breast cancer survivors. We measured anatomical distances used in bra design on 3D clinical photographs of patients who underwent unilateral and bilateral implant-based reconstruction to quantify changes after reconstruction relative to the measured values before the person underwent surgery. We performed additional assessments of symmetry before surgery and after reconstruction, and we used regression analyses to identify associations between the measurements and patient characteristics, such as BMI. Overall, almost all measurements changed significantly in implant-based reconstructed breasts relative to native breasts. We highlight several aspects of ergonomic bra design that will be impacted by the changes in anatomical distances. Practitioner summary: Implant-based breast reconstruction surgery changes the breast so that off-the-rack bras are inadequate. This study provides designers with measurement data from women who underwent implant-based reconstruction to inform bra designs for this population. The key factor designers need to account for is the semi-spherical shape of the reconstructed breast.

Índice de higiene oral simplificado en escolares de 6 años de edad, Ecuador, 2016 / Simplified oral hygiene index in schoolchildren of 6 years of age, Ecuador, 2016

Resumen Introducción: La salud bucal tiene una relación dinámica con la salud general y la calidad de vida de los pacientes. Objetivo del estudio realizado fue determinar el índice de Higiene Oral Simplificado en niños de 6 años de edad de la parroquia Chiquintad del cantón Cuenca, en el año 2016. Métodos: Se manejó una muestra de 51 escolares de ambos sexos, se utilizó el Índice de Higiene Oral Simplificado de Greene y Vermillion aplicado en dentición decidua que consta de un índice de placa blanda y el índice de placa calcificada. Conclusiones: La media de IHO-S en la parroquia Chiquintad fue 0,458 sin presentar una diferencia significativa entre los sexos. El nivel de higiene oral fue bueno en ambos sexos (90%), no se presentó una diferencia estadísticamente significativa entre ambos (valor p 0,389).

Abstract Introduction: Oral health has a dynamic relationship with the general health and quality of life of patients. Objective: of the study was to determine the Simplified Oral Hygiene Index in 6-year-old children of the Chiquintad of the Cantón Cuenca, in the year 2016. Methods: A sample of 51 schoolchildren of both sexes was used, the Hygiene Index was used Simplified oral of Greene and Vermillion applied in deciduous dentition consisting of a soft plaque index and calcified plaque index. Conclusions: The mean of IHO-S in the Chiquintad parish was 0.458 without presenting a significant difference between the sexes. The level of oral hygiene was good in both sexes (90%), there was no statistically significant difference between the two (p value 0.389).

Undergarment needs after breast cancer surgery: a key survivorship consideration.

An important aspect of breast cancer survivorship is finding comfortable undergarments that work for women's post-treatment bodies. Patients who undergo mastectomy, including both those who do and do not receive reconstruction, need bras that can accommodate new breast shape, size, and feel, as well as scarring and skin sensitivity. Our research with breast cancer patients and the literature reveal that ready-to-wear bras are inadequate for the variety of patients' needs, and many women lack support and guidance to make decisions about undergarments after cancer. This commentary describes a major quality-of-life challenge for breast cancer survivors and makes recommendations for future research. Healthcare providers need more guidance and resources to be able to help their patients prepare for this aspect of survivorship. New technologies, such as biomechanical modeling, 3D body scanning, and manufacturing techniques, should be pursued in collaboration with patients, healthcare providers, and clothing designers to ease this burden for breast cancer patients.

Emergence of Plasmid-Borne dfrA14 Trimethoprim Resistance Gene in Shigella sonnei.

The most common mechanism of trimethoprim (TMP)-resistance is the acquisition of dihydrofolate reductase enzyme resistant to this drug. Previous molecular characterization of TMP-genes resistance in Chilean isolates of Shigella sonnei searching for dfrA1 and dfrA8, showed solely the presence of dfrA8 (formerly dhfrIIIc). However, these genetic markers were absent in S. sonnei strains further isolated during an outbreak in 2009. To identify the TMP-resistance gene in these strains, a genomic DNA library from a TMP-resistant (TMP(R)) S. sonnei representative strain for the outbreak was used to clone, select and identify a TMP-resistance marker. The TMP(R) clone was sequenced by primer walking, identifying the presence of the dfrA14 gene in the sul2-strA'-dfrA14-'strA-strB gene arrangement, harbored in a native 6779-bp plasmid. The same plasmid was isolated by transforming with a ~4.2 MDa plasmid extracted from several TMP(R) S. sonnei strains into Escherichia coli. This plasmid, named pABC-3, was present only in dfrA14-positive strains and was homologous to a previously described pCERC-1, but different due to the absence of an 11-bp repetitive unit. The distribution of dfrA1, dfrA8, and dfrA14 TMP-resistance genes was determined in 126 TMP(R) S. sonnei isolates. Most of the strains (96%) carried only one of the three TMP-resistance genes assessed. Thus, all strains obtained during the 2009-outbreak harbored only dfrA14, whereas, dfrA8 was the most abundant gene marker before outbreak and, after the outbreak dfrA1 seems have appeared in circulating strains. According to PFGE, dfrA14-positive strains were clustered in a genetically related group including some dfrA1- and dfrA8-positive strains; meanwhile other genetic group included most of the dfrA8-positive strains. This distribution also correlated with the isolation period, showing a dynamics of trimethoprim genetic markers prevalent in Chilean S. sonnei strains. To our knowledge, dfrA14 gene associated to a small non-conjugative plasmid was detected for the first time in Shigella. Apparently, the strain causing the outbreak must have been introduced, changing drastically the genetic distribution of trimethoprim resistance in Chilean S. sonnei strains.

Índice de higiene oral simplificado en escolares de 6 años de edad, Ecuador, 2016

Introducción: La salud bucal tiene una relación dinámica con la salud general y la calidad de vida de los pacientes. Objetivo del estudio realizado fue determinar el índice de Higiene Oral Simplificado en niños de 6 años de edad de la parroquia Chiquintad del cantón Cuenca, en el año 2016. Métodos: Se manejó una muestra de 51 escolares de ambos sexos, se utilizó el Índice de Higiene Oral Simplificado de Greene y Vermillion aplicado en dentición decidua que consta de un índice de placa blanda y el índice de placa calcificada. Conclusiones: La media de IHO-S en la parroquia Chiquintad fue 0,458 sin presentar una diferencia significativa entre los sexos. El nivel de higiene oral fue bueno en ambos sexos (90%), no se presentó una diferencia estadísticamente significativa entre ambos (valor p 0,389).

Introduction: Oral health has a dynamic relationship with the general health and quality of life of patients. Objective: of the study was to determine the Simplified Oral Hygiene Index in 6-year-old children of the Chiquintad of the Cantón Cuenca, in the year 2016. Methods: A sample of 51 schoolchildren of both sexes was used, the Hygiene Index was used Simplified oral of Greene and Vermillion applied in deciduous dentition consisting of a soft plaque index and calcified plaque index. Conclusions: The mean of IHO-S in the Chiquintad parish was 0.458 without presenting a significant difference between the sexes. The level of oral hygiene was good in both sexes (90%), there was no statistically significant difference between the two (p value 0.389).

Determinacion de la salud bucal en personas mayores institucionalizadas residentes en Lima, Perú / Assessment of oral health in institutionalized elderly residents in Lima, Peru

Evaluar y conocer la salud bucal en personas mayores institucionalizadas, residentes en la ciudad de Lima. Se trabaj¢ en dos centros geri tricos ubicados en dos distritos de la ciudad de Lima. Material y m‚todos. Estudio descriptivo transversal. La muestra estuvo conformada por 24 personas. Se realiz¢ la recopilaci¢n de los datos sociodemogr ficos mediante un cuestionario, una percepci¢n del evaluador sobre el estado de salud extra oral, ATM, estado de las mucosas, presencia y estado de la pr¢tesis dental, frecuencia del cepillado y una percepci¢n de la persona sobre su estado de salud bucodental. Adem s, se aplic¢ el test de Pfeiffer para verificar su estado de orientaci¢n y lucidez, el ¡ndice de Eichner para la oclusi¢n, el ¡ndice diente cariado perdido obturado (CPOD) y el ¡ndice de higiene oral simplificado (IHOS). Resultados. El 33,33% present¢ caries dental, mientras el 66,67% era ed‚ntulo. El promedio del CPOD fue de 27,66. Y el ¡ndice IHOS el 50,00% era malo, teniendo presente que 41,67% era ed‚ntulo parcial o total. Se tuvo la percepci¢n que el 62,50 % ten¡a una salud bucal regular. Seg£n el ¡ndice de Eichner, registrando contacto en premolares y molares, encontramos que el 83,33% estaba en la escala C. En el test de Pfeifer, para conocer el estado de lucidez y orientaci¢n de las personas encontramos que el 41,67% present¢ una funci¢n intelectual intacta. Conclusiones. El estado de salud bucal de los pacientes institucionalizados se encuentra bajo una perspectiva mala, teniendo como premisa que a mayor edad, mayor el edentulismo, sin embargo, la ausencia de piezas dentarias no ha sido condicionante para que las personas sean portadoras de pr¢tesis dentales.

To evaluate and know the oral health of institutionalized elderly residents in the city of Lima. We worked in two elderly homes located in two districts of the city of Lima. Material and methods. It was a descriptive cross-sectional study. The sample consisted of 24 people. Collection of demographic data was made through a questionnaire, a perception of the evaluator on the extra oral health status, ATM, mucosal status, presence and denture status, frequency of brushing and person perception about its performance of their oral health status. Furthermore Pfeiffer test was applied to verify the status of guidance and clarity; Eichner index for occlusion, the index lost sealed carious tooth (DMFT) and the simplified oral hygiene index (OHI). Results. 33.33% presented dental caries, while 66.67% were edentulous. The average of DMFT was 27.66. And the OHI index 50.00% was bad, considering that 41.67% were partially or totally edentulous. Perception that 62.50% had a regular oral health were reported. According to Eichner index, recording contact in premolars and molars, found that 83.33% were in level C. The test Pfeifer, to know the state of alertness and orientation of people find that 41.67% had an intact intellectual function. Conclusions. The oral health status of institutionalized patients is under a bad perspective, with the premise that the older ones had more edentulism, however the lack of teeth has not been conditioning for people to carry dentures.

Comparación del espesor de la vía aérea entre pacientes bruxómanos y no bruxomanos

El bruxismo puede tener consecuencias en la dentición, musculatura, ATM y la postura cefálica y corporal de quien lo sufre. El objetivo de este estudio fue evaluar y comparar las dimensionesde la vía aérea superior entre pacientes adultos jóvenes bruxómanos y no bruxómanos.