Impact of polyurethane versus acellular dermal matrix coating on prepectoral reconstruction outcomes: Interface does matter.

BACKGROUND: Interfaces continue to be used in prepectoral breast reconstruction to refine breast appearance, but more clinical data are required to assess their effectiveness. This study compares the rates of capsular contracture, breast esthetics, and patient satisfaction between two commonly used interface materials, acellular dermal matrix (ADM) and polyurethane (PU) foam. METHODS: A cross-sectional assessment was conducted on all patients who underwent prepectoral direct-to-implant reconstruction with an interface material between June 2018 and June 2022. We compared capsular contracture rates (assessed in-person), esthetic outcomes (evaluated by a three-member panel using a specially designed scale), and patient satisfaction (measured using the Breast-Q questionnaire) among the members of the interface groups. RESULTS: Among the 79 reconstructed breasts (20 bilateral cases), 35 were reconstructed using ADM and 44 using PU implants. The ADM group had a significantly higher frequency of Baker III/IV capsular contracture compared with the PU group (14.3% vs. 0%, p = 0.014) and lower ratings from the panel in terms of capsular contracture (median 3.7 vs. 4.0, p < 0.001). PU reconstructions scored worse in implant visibility (median 2.3 vs. 3.3, p < 0.001) and rippling (median 3.0 vs. 3.7, p < 0.001). However, after appropriate adjustment for confounders, no significant differences in overall appearance and patient satisfaction were found. CONCLUSIONS: ADM reconstructions are prone to capsular contracture with all their related esthetic issues, but PU implants have certain cosmetic flaws, such as implant visibility and malposition. Since each technique has its own limitations, neither the experienced surgeons nor patients exhibited a clear preference for either approach.

Refining reconstructive arsenal: Free omental flap with autologous bone graft for complex craniofacial defects after tumor resection and frontal osteoradionecrosis.

Skull osteoradionecrosis may happen after radiation therapy for head and neck cancer. Here in, the authors present a case of intracranial carcinoma with osteoradionecrosis and exposure of frontal bone with a large communication between nasal cavity and anterior fossa associated. The patient was successfully treated with resection of the tumor and reconstruction omentum free flap wrapped around autologous bone graft.

Primary care doctor's perception about the scope of plastic surgeons: A national survey.

BACKGROUND: Plastic surgery is characterized by a broad spectrum of aesthetic and reconstructive surgical expertise that is not defined by an anatomic area. The authors sought to identify primary care doctors' perceptions of different fields of plastic surgery. METHODS: A short, anonymous, web-based survey was administered to primary care doctors in Portugal. Respondents were asked to choose the specialist they perceived to be an expert for 29 specific clinical areas, including 20 that are the core of plastic surgery practice. Specialists for selection included the following choices: dermatologist, general surgeon, maxillofacial surgeon, vascular surgeon, neurosurgeon, orthopedic surgeon, otolaryngologist, and plastic surgeon. RESULTS: A total of 430 complete answers to the survey were collected. Out of the 20 clinical cases related to plastic surgery, only nine were attributed to plastic surgery in the majority of the answers: thumb reimplantation (64,2%), abdominoplasty (93%), breast reduction (94%), otoplasty (62,3%), skin graft for a burn (97,7%), breast reconstruction (94,9%), complex open wound (57,2%), facial reanimation (36,7%) and first web space contracture of the hand (78,6%). CONCLUSIONS: There is a clear underestimation of the role of plastic surgery in a wide range of conditions, which may lead to the downsizing of plastic surgery departments in the national health system. It is of utmost importance to educate primary care doctors so that patients are referred correctly and in a timely manner.

Use of flaps in inguinal lymphadenectomy in metastatic penile cancer

ABSTRACT Purpose: Reviewing surgical procedures using fasciocutaneous and myocutaneous flaps for inguinal reconstruction after lymphadenectomy in metastatic penile cancer. Material and Methods: We reviewed the current literature of the Pubmed database according to PRISMA guidelines. The search terms used were "advanced penile cancer", "groin reconstruction", and "inguinal reconstruction", both alone and in combination. The bibliographic references used in the selected articles were also analyzed to include recent articles into our research. Results: A total of 54 studies were included in this review. About one third of penile cancers are diagnosed with locally advanced disease, often presenting with large lymph node involvement. Defects in the inguinal region resulting from the treatment of metastatic penile cancer are challenging for the surgeon and cause high patient morbidity, rendering primary closure unfeasible. Several fasciocutaneous and myocutaneous flaps of the abdomen and thigh can be used for the reconstruction of the inguinal region, transferring tissue to the affected area, and enabling tensionless closure. Conclusions: The reconstruction of defects in the inguinal region with the aid of flaps allows for faster postoperative recovery and reduces the risk of complications. Thus, the patient will be able to undergo potential necessary adjuvant treatments sooner.

Use of flaps in inguinal lymphadenectomy in metastatic penile cancer.

PURPOSE: Reviewing surgical procedures using fasciocutaneous and myocutaneous flaps for inguinal reconstruction after lymphadenectomy in metastatic penile cancer. MATERIAL AND METHODS: We reviewed the current literature of the Pubmed database according to PRISMA guidelines. The search terms used were "advanced penile cancer", "groin reconstruction", and "inguinal reconstruction", both alone and in combination. The bibliographic references used in the selected articles were also analyzed to include recent articles into our research. RESULTS: A total of 54 studies were included in this review. About one third of penile cancers are diagnosed with locally advanced disease, often presenting with large lymph node involvement. Defects in the inguinal region resulting from the treatment of metastatic penile cancer are challenging for the surgeon and cause high patient morbidity, rendering primary closure unfeasible. Several fasciocutaneous and myocutaneous flaps of the abdomen and thigh can be used for the reconstruction of the inguinal region, transferring tissue to the affected area, and enabling tensionless closure. CONCLUSIONS: The reconstruction of defects in the inguinal region with the aid of flaps allows for faster postoperative recovery and reduces the risk of complications. Thus, the patient will be able to undergo potential necessary adjuvant treatments sooner.

Unraveling structural and compositional information in 3D FinFET electronic devices.

Non-planar Fin Field Effect Transistors (FinFET) are already present in modern devices. The evolution from the well-established 2D planar technology to the design of 3D nanostructures rose new fabrication processes, but a technique capable of full characterization, particularly their dopant distribution, in a representative (high statistics) way is still lacking. Here we propose a methodology based on Medium Energy Ion Scattering (MEIS) to address this query, allowing structural and compositional quantification of advanced 3D FinFET devices with nanometer spatial resolution. When ions are backscattered, their energy losses unfold the chemistry of the different 3D compounds present in the structure. The FinFET periodicity generates oscillatory features as a function of backscattered ion energy and, in fact, these features allow a complete description of the device dimensions. Additionally, each measurement is performed over more than thousand structures, being highly representative in a statistical meaning. Finally, independent measurements using electron microscopy corroborate the proposed methodology.

Versatilidad del colgajo famm para la cobertura de defectos intraorales / Versatility of the famm flap in intraoral reconstruction / Versatilidade do retalho FAMM na cobertura de defeitos intra-orais

Introducción y Objetivo: El colgajo FAMM (colgajo músculo-mucoso de arteria facial) descrito en 1992 por Pribaz y col, es un colgajo intraoral basado en la arteria facial, compuesto por mucosa oral, submucosa, músculo bucinador, arteria facial y por el plexo venoso correspondiente y puede ser de base inferior (flujo anterógrado) o superior (flujo retrógrado). Es un colgajo versátil que se puede usar en la reconstrucción de defectos de múltiples localizaciones (paladar, lengua o suelo de boca). Con este trabajo pretendemos demostrar su utilidad en la reconstrucción de diferentes defectos intraorales. Material y Método: Presentamos 3 casos en lo que empleamos el colgajo FAMM para reconstrucción intraoral: un paciente con anquiloglosia cicatricial secuela de carcinoma de suelo de boca, un paciente con fístula de paladar secuela de resección tumoral, y un paciente con exposición intraoral de arco mandibular por osteonecrosis secundaria a bifosfonatos. Resultados: Todos los colgajos sobrevivieron al 100% y permitieron una cobertura estable y duradera, con ausencia de complicaciones mayores. Conclusiones: El colgajo FAMM permite la reconstrucción de defectos intraorales y periorales con tejido bien vascularizado y de idénticas características a las de la zona a reconstruir, con baja morbilidad de la zona donante, lo que lo convierte en una excelente opción reconstructiva para defectos de esta región anatómica

Background and Objective: The facial artery musculo-mucosal (FAMM) flap, first described by Pribaz et al. in 1992, is an intraoral flap based on the facial artery. It is composed of mucosa, submucosa, buccinator muscle and the facial artery along with its venous plexus. The design of the flap can be inferiorly-based and rely on antegrade blood flow or superiorly-based with retrograde flow. The FAMM flap is a versatile flap that can be used for the reconstruction of defects of multiple locations (palate, lips, tongue, and floor of the mouth). The purpose of this study is to demonstrate the utility of the FAMM flap in the reconstruction of different intraoral defects. Methods: In this article the authors present 3 cases in which the FAMM flap was used for intraoral reconstruction: one patient with a history of ankyloglossia sequelae of a squamous cell carcinoma of the floor of the mouth; one patient with a palatal fistula sequelae of tumor excision; and one patient with a biphosphonate-related osteonecrosis of the mandible. Results: All flaps survived and provided a stable and reliable coverage of the defect. There were no major complications. Conclusions: The FAMM flap is a well vascularized flap that replaces like with like tissue. Because of its low morbidity, low rate of complications and reliable results, the FAMM flap is an excellent option for reconstruction of small to moderate intra-oral defects

Introdução e Objetivo: O retalho FAMM (facial artery musculo-mucosal flap), descrito em 1992 por Pribaz et al., é um retalho intra-oral baseado na artéria facial. É composto por mucosa oral, submucosa, músculo bucinador, artéria facial e pelo plexo venoso correspondente, podendo basear-se inferior (fluxo anterógrado) ou superiormente (fluxo retrógrado). É um retalho versátil que pode ser utilizado nareconstrução de defeitos em múltiplas localizações (palato, lábio, língua, pavimento da boca). Com este trabalho pretende-se demonstrar a utilidade do retalho FAMM na reconstrução de diferentes defeitos intra-orais. Material e Métodos: Os autores apresentam 3 casos em que se utilizou o retalho FAMM para reconstrução intra-oral: um doente com anquiloglossia cicatricial sequelar de carcinoma do pavimento da boca; uma doente com uma fístula do palato sequela de excisão tumoral; e um doente com exposição intra-oral do arco mandibular anterior por osteonecrose secundária a bifosfonatos. Resultados: Todos os retalhos sobreviveram a 100% e permitiram uma cobertura estável e duradoura, na ausência de complicações major. Conclusão: O retalho FAMM permite a reconstrução de defeitos intra e peri-orais com tecido bem vascularizado e de características idênticas à zona a reconstruir, com baixa morbilidade da zona dadora, o que o torna uma excelente opção reconstrutiva para defeitos desta região anatómica

Tuning the structure and magnetic behavior of Ni-Ir-based nanoparticles in ionic liquids.

We report on a simple preparation of extremely small diameter (ca. 2 nm) Ni-Ir-based NPs using Ni(COD)2 and [Ir(COD)OCH3]2 in 1-butyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide (BMIm·NTf2). The prepared NPs had either core-shell-like or alloy-like structures with the presence of Ni,Ir-oxides, depending on the synthetic approach. X-ray diffraction (XRD), Rutherford backscattering spectrometry (RBS), high-resolution transmission electron microscopy (HRTEM), X-ray photoelectron spectroscopy (XPS), extended X-ray absorption fine structure (EXAFS), and magnetic measurements are combined to describe the influence of nanostructure on the magnetic behavior of these nanosystems. The present findings reveal that the alloy NPs display a disordered magnetic state, similar to a spin glass (SG)-like system (Tf = 7.2 K). Core-shell NPs are formed by a magnetically blocked/unblocked core with a magnetically disordered shell as deduced from the two magnetic responses peaking at TB = 75 K and Tf = 5.8 K. Coupling at the core-shell interface leads to an exchange bias revealed at low temperature as horizontal shifts in the hysteresis loops of 0.12 kOe at 2 K.

Confined naked gold nanoparticles in ionic liquid films.

Surface-clean Au nanoparticles (NPs) confined in films of ionic liquids (ILs) can be easily fabricated by sputtering deposition. A silicon wafer coated with films of both hydrophobic (bis((trifluoromethyl)sulfonyl)amide, NTf2-) and hydrophilic (tetrafluoroborate, BF4-) imidazolium-based ILs forms an 'ionic carpet-like' structure that can be easily decorated with Au NPs of 5.1 and 6.5 nm mean diameter, respectively. The depth profile distribution of the Au NPs depends on the arrangement of the IL, which is controlled mainly by the anion volume. Higher concentrations of Au NPs are found closer to the IL surface for the system containing a larger anion (NTf2) whereas Au NPs are located deeper in the IL for the system containing a smaller anion (BF4). The Au NPs are well distributed over the IL/Si support and are strictly confined in a single layer of the IL. This method is among the most simple and versatile for the generation of liquid layers containing surface-clean, stable and confined Au NPs.

Helminths as an alternative therapy for intestinal diseases.

Animal models and clinical studies have shown that helminth infections exert immunomodulatory activity, altering intestinal permeability and providing a potential beneficial action on autoimmune and inflammatory disorders in human beings, such as inflammatory bowel disease (IBD) and celiac disease. This is consistent with the theory that intestinal microbiota is responsible for shaping human immunological responses. With the arrival of the immunobiologic era and the use of antibodies, we propose a distinctive pathway for treating patients with IBD and celiac disease. We have some evidence about the safety and tolerability of helminth use, but evidence about their impact on disease activity is lacking. Using worms to treat diseases could be a possible way to lower treatment costs, since the era of immunobiologic agents is responsible for a significant rise in expenses. Some questions remain to be investigated regarding the use of helminths in intestinal disease, such as the importance of the specific species of helminths used, appropriate dosing regimens, optimal timing of treatment, the role of host genetics, diet, environment, and the elucidation of the exact mechanisms of action. One promising approach is the use of helminth-derived anti-inflammatory molecules as drugs. Yet there are still many challenges with this method, especially with regard to safety. Studies on intestinal permeability point to Strongyloides stercoralis as a useful nematode for these purposes.

Synergizing nanocomposites of CdSe/TiO2 nanotubes for improved photoelectrochemical activity via thermal treatment.

In this work, we show the effect of the thermal treatment temperature on the photoelectrochemical (PEC) activity of CdSe/TiO2 nanocomposites. TiO2 nanotubes (NTs) were synthesized by anodization and the nanocomposites were obtained by depositing CdSe clusters via magnetron sputtering. A two-step thermal treatment was performed: heating the TiO2 NTs at different temperatures prior to CdSe deposition and further heating the CdSe/TiO2 nanocomposites. The nanocomposites were characterized by Rutherford backscattering spectroscopy (RBS), scanning electron microscopy (SEM), scanning transmission electron microscopy (STEM), high-resolution transmission electron microscopy (HRTEM), energy dispersive X-ray spectroscopy (EDX), X-ray diffraction (XRD), UV-Vis spectrophotometry, and electrochemical impedance spectroscopy (EIS). To compare the PEC performance of the CdSe/TiO2 nanocomposites and pristine TiO2 NTs, linear sweep voltammetry (LSV) curves were obtained under visible light and under 1 sun illumination. It was observed that CdSe incorporation into the TiO2 template enhances the visible light absorbance thereby improving the PEC performance of the nanocomposites. We have found that the optical, structural and PEC properties of the CdSe/TiO2 nanocomposites are dependent on the thermal treatment temperature of the TiO2 nanotubular substrate, prior to CdSe deposition. Moreover, a three-fold improvement in photocurrent was observed upon further thermal treatment of the obtained nanocomposite.

On the Structural and Chemical Characteristics of Co/Al2O3/graphene Interfaces for Graphene Spintronic Devices.

We report a detailed investigation of the structural and chemical characteristics of thin evaporated Al2O3 tunnel barriers of variable thickness grown onto single-layer graphene sheets. Advanced electron microscopy and spectrum-imaging techniques were used to investigate the Co/Al2O3/graphene/SiO2 interfaces. Direct observation of pinhole contacts was achieved using FIB cross-sectional lamellas. Spatially resolved EDX spectrum profiles confirmed the presence of direct point contacts between the Co layer and the graphene. The high surface diffusion properties of graphene led to cluster-like Al2O3 film growth, limiting the minimal possible thickness for complete barrier coverage onto graphene surfaces using standard Al evaporation methods. The results indicate a minimum thickness of nominally 3 nm Al2O3, resulting in a 0.6 nm rms rough film with a maximum thickness reaching 5 nm.

Hydrophobic effects on supported ionic liquid phase Pd nanoparticle hydrogenation catalysts.

Hybrid organosilicas prepared by sol-gel processes using 1-n-butyl-3-(3-trimethoxysilylpropyl)-imidazolium cations associated with hydrophilic and hydrophobic anions can be easily decorated with well dispersed and similar size (1.8-2.1 nm) Pd nanoparticles (Pd-NPs) by simple sputtering-deposition. Higher Pd concentration at the surface compared to the deeper region is obtained in the supports with smaller pore diameter (containing hydrophobic ILs) than in supports with the largest pore diameter (containing hydrophilic ILs). The IL hydrophobicity plays a central role in the hydrogenation of dienes by controlling the diene access to NP surface active sites.

Straightforward synthesis of bimetallic Co/Pt nanoparticles in ionic liquid: atomic rearrangement driven by reduction-sulfidation processes and Fischer-Tropsch catalysis.

Unsupported bimetallic Co/Pt nanoparticles (NPs) of 4.4 ± 1.9 nm can be easily obtained by a simple reaction of [bis(cylopentadienyl)cobalt(ii)] and [tris(dibenzylideneacetone) bisplatinum(0)] complexes in 1-n-butyl-3-methylimidazolium hexafluorophosphate IL at 150 °C under hydrogen (10 bar) for 24 h. These bimetallic NPs display core-shell like structures in which mainly Pt composes the external shell and its concentration decreases in the inner-shells (CoPt3@Pt-like structure). XPS and EXAFS analyses show the restructuration of the metal composition at the NP surface when they are subjected to hydrogen and posterior H2S sulfidation, thus inducing the migration of Co atoms to the external shells of the bimetallic NPs. Furthermore, the isolated bimetallic NPs are active catalysts for the Fischer-Tropsch synthesis, with selectivity for naphtha products.

Analysis of microleakage of temporary restorative materials in primary teeth.

AIM: The aim of this study was to compare the coronal microleakage of restorative materials used between sessions of endodontic treatment in primary teeth. MATERIALS AND METHODS: Forty healthy primary canines were chosen and randomly allocated to four groups: Group 1 - Cimpat Branco ® (n = 10), Group 2 - Bioplic ® (n = 10), Group 3 - Maxxion R ® glass ionomer cement (n = 10), and Group 4 (control) - Z350 ® composite resin (n = 10). Class V cavities were created and fillings carried out following the manufacturer's instructions. The teeth were submitted to thermocycling, sealed, and immersed in 0.5% basic fuchsin solution for 24 h. The teeth were split along their long axis in the vestibulolingual direction and the tooth-restorative material interface was photographed. The percentage of microleakage was calculated using the ImageJ program. Data were analyzed using the analysis of variance (ANOVA) F-test and Bonferroni's t-test, with a 5% level of significance. RESULTS: The following mean percentages of microleakage were found: Group 1 = 16.08%, Group 2 = 46.98%, Group 3 = 47.93%, and Group 4 = 11.03%. Statistically, significant differences were found in the comparison of Groups 1 and 4 to Groups 2 and 3. CONCLUSION: Cimpat Branco ® had a lower percentage of microleakage in comparison to Bioplic ® and Maxxion R ® glass ionomer cement.

New approach for structural characterization of planar sets of nanoparticles embedded into a solid matrix.

In this work we demonstrate that Medium Energy Ion Scattering (MEIS) measurements in combination with Transmission Electron Microscopy (TEM) or Grazing Incidence Small Angle X-Ray Scattering (GISAXS) can provide a complete characterization of nanoparticle (NP) systems embedded into dielectric films. This includes the determination of the nanoparticle characteristics (location, size distribution and number concentration) as well as the depth distribution and concentration of the NP atomic components dispersed in the matrix. Our studies are performed considering a model case system consisting of planar arrangements of Au NPs (size range from 1 to 10 nm) containing three distinct Au concentrations embedded in a SiO2 film.

Interfaces in nano-/microcrystalline multigrade CVD diamond coatings.

The interfaces of multilayered CVD diamond films grown by the hot-filament technique were characterized with high detail using HRTEM, STEM-EDX, and EELS. The results show that at the transition from micro- (MCD) to nanocrystalline diamond (NCD), a thin precursor graphitic film is formed, irrespectively of the NCD gas chemistry used (with or without argon). On the contrary, the transition of the NCD to MCD grade is free of carbon structures other than diamond, the result of a higher substrate temperature and more abundant atomic H in the gas chemistry. At those transitions WC nanoparticles could be found due to contamination from the filament, being also present at the first interface of the MCD layer with the silicon nitride substrate.

Correção de flacidez de pele nas regiões glútea e lombar com retalho fasciocutâneo local em cambalhota / Correction of sagging skin the gluteal and lumbar regions using a fasciocutaneous local flap

Um dos maiores problemas dos pacientes pós-cirurgia bariátrica é o excedente de pele nas regiões glútea e lombar. Somado a isso, há escassez de tecido para preencher a região glútea, que pode ser corrigida por vários métodos, entre eles a lipoenxertia ou, ainda, o implante de prótese isoladamente, nos casos em que não haja ptose. Se o contrário ocorre, essas opções tornam-se muito limitadas e pouco expressivas. O lifting glúteo com emprego de retalho fasciocutâneo em cambalhota permite resolver tanto a flacidez como o excesso de pele com ptose. Este trabalho tem por objetivo demonstrar a facilidade de confecção e a versatilidade de utilização do retalho glúteo em cambalhota para correção de flacidez das regiões glútea e lombar. Uma paciente foi submetida ao procedimento cirúrgico de lifting glúteo associado ao emprego de retalho fasciocutâneo desepidermizado em cambalhota, para correção de falta de preenchimento local. Melhora acentuada das regiões glútea e lombar foi obtida após a retirada do excesso de tecido superior, confecção de um retalho fasciocutâneo de pedículo inferior e tração da pele. Além disso, a rotação do retalho e sua fixação ao músculo glúteo melhoraram acentuadamente o contorno posterior da paciente, com pós-operatório bastante cômodo. Com morbidade mínima, foi retirado o excesso cutâneo e, concomitantemente, aumentada a região glútea com retalho autólogo, que é desprezado durante a execução de muitas técnicas, melhorando o contorno da paciente e deixando uma cicatriz discreta, que poderá ser ocultada pelas roupas íntimas.

A major problem for patients after bariatric surgery is the excess skin in the gluteal and lumbar regions. In addition, there is a lack of available tissue to fill the gluteal region, which can be overcome by various methods, including fat grafting or even prosthesis implantation alone, in cases where no ptosis is noted. However, if this is not the case, the options become very limited and those available are not very effective. The use of a buttock lift with a fasciocutaneous flap solves the problems of sagging and excess skin with ptosis. In the present article, we aimed to demonstrate the ease of preparation and the versatility of use of the gluteal flap to correct sagging of the lumbar and gluteal regions. One patient underwent a buttock lift using a de-epidermized fasciocutaneous flap to overcome the lack of local filling. Marked improvement of the gluteal and lumbar regions was noted after removal of the excess tissue, construction of an inferior fasciocutaneous flap, and use of skin traction. In addition, rotation of the flap and its attachment to the gluteal muscle markedly improved the patient's posterior contour and postoperative comfort. With minimal morbidity, excess skin was removed and the gluteal region was concomitantly increased using an autologous flap that is neglected in many techniques; this resulted in an improved contour and a discreet scar that could be hidden by the patient's underwear.