ABSTRACT
INTRODUCTION: Current breast cancer treatment trends advocate nipple-sparing mastectomy (NSM) as the preferred technique for selected patients. A considerable and ptotic breast is often considered a relative contraindication for NSM due to the increased risk of skin and nipple necrosis. METHODS: A retrospective review was performed for patients who underwent immediate prepectoral breast reconstruction (PPBR) after NSM with Wise-pattern incision between February 2020 and February 2023 at our institution. This procedure was offered to patients with grade II or III ptosis or large breasts eligible for NSM for therapeutic or prophylactic purpose. Exclusion criteria comprised a preoperative nipple-sternal notch distance greater than 30 cm, previous radiotherapy, pinch test <1 cm, body mass index (BMI) greater than 34 and active smoke. We present our short-term results with this technique. RESULTS: During the study period, 62 patients (76 breasts) had NSM with Wise-pattern incision. Patients had immediate PPBR with implant or tissue expander, both entirely wrapped with ADM. The median age of the patients was 57.0 years [The Interquartile Range (IQR 50.0-68.6)] with a median BMI of 25.5 (IQR 23.3-28.4). The median mastectomy specimen weight was 472 g (341-578). Median implant volume was 465 g (IQR 370-515). Major complications occurred in 8 patients (10.5%). Three patients experienced total nipple-areolar complex (NAC) necrosis (3.9%), and partial NAC necrosis occurred in 2 patients (2.6%). Two patients developed implant infection (2.6%). Univariate analysis showed a statistically significant correlation between major complications and the mastectomy specimen weight (p = 0.003). CONCLUSION: If oncologically indicated, NSM with Wise-pattern incision and immediate PPBR can safely be performed in selected patients with large and ptotic breasts.
Subject(s)
Breast Neoplasms , Mammaplasty , Mastectomy, Subcutaneous , Humans , Middle Aged , Female , Mastectomy/methods , Breast Neoplasms/etiology , Nipples/surgery , Mammaplasty/methods , Mastectomy, Subcutaneous/methods , Retrospective Studies , Necrosis/etiologyABSTRACT
Objective: The prevalence of overweight and obesity in Spanish children has increased considerably in the last decades. Obesity has been recognized as a public health problem in developed countries because its association with increased risk for several pathologies. Obesity in children and, specifically, in adolescents, is a major concern. Actually, in Spain, the prevalence rates of childhood overweight and obesity are among the highest in European countries. The objective of this study was to measure the prevalence of overweight and obesity in children from Seville. Method: A cross-sectional study was performed on 990 children, aged 8-9 years old (51.5% 8-year old and 48.5% 9-year old). Overweight and obesity were defined according to two methods: Spanish standards, applying the criterion of BMI-specific percentiles for age and sex, and the international standards established by Cole et al. (IOTF). Results: A high prevalence of overweight (11%) and obesity (22%) was observed. The prevalence of obesity as well as the prevalence of overall excess weight was significantly higher in 9-year old children (28% and 41%, respectively) than in 8-year old children (17% and 27%, respectively). Conclusion: The prevalence of overweight and obesity among Sevillian school children is high, and increases in the studied range of age (AU)
Objetivo: La prevalencia de sobrepeso y obesidad infantil ha aumentado durante las últimas décadas en España. La obesidad se ha convertido en un problema de salud pública en los países desarrollados por su influencia en el aumento del riesgo de padecer ciertos tipos de enfermedades. Este problema se manifiesta especialmente en escolares y adolescentes. En España, este aumento de la prevalencia de sobrepeso y obesidad infantil le ha hecho llegar a ocupar una de las primeras posiciones en las tasas de sobrepeso y obesidad europeas. El objetivo de este estudio es determinar la prevalencia de sobrepeso y obesidad en niños sevillanos. Método: Se realizó un estudio epidemiológico transversal en 990 niños de edades comprendidas entre 8 y 9 años (51,5% de 8 años y 48,5% de 9 años). Se definió el sobrepeso y la obesidad según dos métodos: los estándares españoles, usando como criterio los puntos de corte del IMC correspondientes a percentiles específicos por edad y sexo, y los estándares internacionales establecidos por Cole y cols. (IOTF). Resultados: Se ha observado una prevalencia alta de sobrepeso (11%) y obesidad (22%). Tanto la prevalencia de obesidad como de la carga ponderal total han sido significativamente superiores en niños de 9 años (28% y 41%, respectivamente) que en niños de 8 años de edad (17% y 27%, respectivamente). Conclusiones: La prevalencia de sobrepeso y obesidad en niños escolares de una población de Sevilla es alta, y aumenta especialmente en el rango de edad estudiado (AU)
Subject(s)
Humans , Male , Female , Child , Nutrition Assessment , Obesity/epidemiology , Overweight/epidemiology , Risk Factors , Body Mass Index , Weight by HeightABSTRACT
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Subject(s)
Adolescent , Child , Humans , Diabetes Mellitus, Type 1/therapy , Diabetes Mellitus, Type 2/therapy , Islets of Langerhans Transplantation , Stem Cell Transplantation , Immunosuppression Therapy/methods , Treatment Outcome , Tissue and Organ Procurement/trendsABSTRACT
No disponible