Effect of Reduction Mammoplasty on Pulmonary Function Tests: A Systematic Review.

ABSTRACT: In patients with breast hypertrophy, excessive breast weight applies pressure on the thorax, which may disrupt the normal breathing. The purpose of this study is to evaluate the impact of the breast hypertrophy and reduction mammoplasty on respiratory function. A comprehensive search of 3 databases, PubMed, Ovid, and Scopus databases, was performed. "Mammoplasty" and "respiration or pulmonary function tests" were the keywords used to search for relevant articles. Ten studies involving 280 patients with breast hypertrophy were included in the final review. Seven articles demonstrated an increase in at least 1 pulmonary function test value after the surgery. This systematic review revealed that, preoperatively, pulmonary function test values of the patients are usually in the normal range. Nonetheless, reduction mammoplasty still improves lung function parameters. Additionally, patients with respiratory complaints felt improvement in their symptoms after the surgery. However, future studies are needed, as heterogeneity among studies was observed.

Experimental Studies of Latissimus Dorsi Detrusor Myoplasty for Bladder Acontractility: A Systematic Review.

Current therapies that allow patients with bladder acontractility to void are limited. The standard therapy is clean intermittent catheterization. Latissimus dorsi detrusor myoplasty (LDDM) has been shown to provide functional contraction and allow patients with bladder acontractility to void voluntarily. Our goal was to summarize experimental studies of LDDM. We hypothesized that experimental studies would show that latissimus dorsi muscle (LDM) flaps for detrusor myoplasty have superior outcomes when compared with other types of flaps. On January 17, 2020, we conducted a systematic review of the PubMed/MEDLINE, Cochrane Clinical Answers, Cochrane Central Register of Controlled Trials, and EMBASE databases, without time frame limitations, to identify articles on the use of LDDM. We excluded studies that investigated other treatments. Of 54 articles identified by the search, three fulfilled the eligibility criteria. A total of 24 dogs underwent procedures and were evaluated with a maximum follow-up of 9 months. Three types of procedures were performed: LDM in situ reconfiguration, LDM myoplasty, and augmentation cystoplasty after supratrigonal cystectomy. Electrical stimulation, cystography, urodynamic and hydrodynamic measurements, and microscopic examinations were performed. Innervated LDM flaps transferred to the bladder were able to contract and promote voiding in response to electrical stimulation. Experimental studies have shown the feasibility of LDDM in canine models. Although no comparison groups were included, innervated LDM flap transferred to the bladder showed promising results regarding contraction capable of voiding.

Latissimus dorsi detrusor myoplasty for bladder acontractility: a systematic review.

Bladder acontractility affects several thousand patients in the United States, but the available therapies are limited. Latissimus dorsi detrusor myoplasty (LDDM) is a therapeutic option that allows patients with bladder acontractility to void voluntarily. Our goal was to conduct a systematic review of the literature to determine whether LDDM is a better option than clean intermittent catheterization (CIC) (standard treatment) in patients with bladder acontractility. On January 17, 2020, we conducted a systematic review of the PubMed/MEDLINE, Cochrane Clinical Answers, Cochrane Central Register of Controlled Trials, Embase, and ClinicalTrials.gov databases, without time frame limitations, to identify articles on the use of LDDM for bladder acontractility. Of 75 potential articles, 4 fulfilled the eligibility criteria. The use of LDDM to treat patients with bladder acontractility was reported in four case series by the same group in Europe. Fifty-eight patients were included, and no comparison groups were included. The most common cause of bladder acontractility was spinal cord injury (n=36). The mean (±standard deviation) operative time was 536 (±22) minutes, postoperative length of hospital stay ranged from 10 to 13 days, and follow-up ranged from 9 to 68 months. Most patients had complete response, were able to void voluntarily, and had post-void residual volume less than 100 mL. Although promising outcomes have been obtained, evidence is still weak regarding whether LDDM is better than CIC to avoid impairment of the urinary tract among patients with bladder acontractility. Further prospective studies with control groups are necessary.

Oil injection for cosmetic enhancement of the upper extremities: a case report and review of literature.

Here the authors report a case of complications occured after injection of a site enhancement oil in the upper extremity for cosmetic muscles' volume enhancement and a literature review on the topic. The medical and sports communities should be aware of the secondary effects of site enhancement oils use, which could bring to severe complications.

Autologous Fat Injection versus Lundborg Resection Arthroplasty for the Treatment of Trapeziometacarpal Joint Osteoarthritis.

BACKGROUND: Various operative approaches exist for treatment of trapeziometacarpal joint osteoarthritis. The aim of this study was to compare the results of Lundborg resection arthroplasty with solely autologous fat injection. METHODS: Twenty-one patients with symptomatic osteoarthritis of the trapeziometacarpal joint (Eaton-Littler classification stages III/IV) underwent either a Lundborg resection arthroplasty (n = 12) or autologous fat injection into the trapeziometacarpal joint (n = 9). Both groups were comparable regarding demographic and clinical data. Patient records were evaluated retrospectively regarding operative time; Disabilities of the Arm, Shoulder, and Hand questionnaire score; postoperative time until resolution of symptoms; pain level; grip and pinch force; and satisfaction with the treatment. RESULTS: Both groups had similar length of follow-up of at least 12 months. The duration of the operation was significantly shorter in the fat group (13 ± 5 minutes) compared with the resection group (31 ± 5 minutes) (p < 0.05). The Disabilities of the Arm, Shoulder, and Hand questionnaire score (resection group, 21.9 ± 6.2; fat group, 24.0 ± 5.0) and the pain level at follow-up (resection group, 1.0 ± 0.7; fat group, 2.9 ± 0.8) were comparable (p > 0.05). The time until complete resolution of symptoms was significantly shorter in the fat group (1.7 ± 2.1 months) compared with the resection group (5.7 ± 3.1 months) (p < 0.05). Grip and pinch strength and overall satisfaction with the treatment were comparable (p > 0.05). CONCLUSION: Both autologous fat grafting and Lundborg resection arthroplasty resulted in improved function of the operative hand and a clear reduction of symptoms, whereas autologous fat injection seems to have advantages attributable to a shorter time until resolution of symptoms and shorter operative times. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Nasal aesthetics: a cross-cultural analysis.

BACKGROUND: Plastic surgeons often approach nasal aesthetic evaluation with the aid of seemingly objective measurements. However, ideal measurements of an attractive nose, as suggested in the literature, might not apply on a cross-cultural basis. Given these controversies, this study aimed to investigate the cultural and ethnic impact on nasal shape preferences. METHODS: Computerized images of a model's nose were generated in which the nasal width, root, tip, dorsum, and projection of the lips and chin could be altered. A survey containing these images was sent to over 13,000 plastic surgeons and lay people in 50 different countries, with a total response rate of 9.6 percent. Demographic information about the interviewees was obtained. RESULTS: Preferred dimensions of the nose were broken down according to geographic, ethnic, occupational, and sex variables. Interregional comparison revealed that plastic surgeons from Latin America and the Caribbean overall prefer smaller and narrower noses, with more projecting tips, lips, and chins. Similar trends hold true when analyzing results from the general public. Significant differences were found comparing preferences between plastic surgeons and the general public. Plastic surgeons preferred wider nasal roots and tips and, in combination, more projected nasal dorsi, tips, lips, and chins. CONCLUSIONS: No universal parameter can define ideal aesthetics of the nose across cultures and ethnic backgrounds. As demonstrated, geographic, ethnic, and cultural factors influence aesthetic perceptions of patients and surgeons.