Left ventricular assist devices are lifesaving interventions for patients with severe cardiac disease but are associated with a high rate of infectious complications over time. Although device coverage carries a high rate of complications, no devices required exchange due to infection or failed attempts at salvage.
Since its inception in 1955, Millard's rotation-advancement repair has been one of the most popular techniques used in the care of patients with a cleft lip. Over the past half century, Millard's repair has evolved and laid the foundation for many other repair techniques that have followed in its footsteps. This publication compares Millard's rotation-advancement technique to the various repairs used today. The purpose of this article is to lend perspective as to the impact of Millard repair over the past 50 years in the treatment of cleft lip.
Gangrenous cholecystitis (GC) is a severe and potentially deadly complication of acute cholecystitis. We present a 83-year-old gentleman with a past medical history of type 2 diabetes mellitus with significant associated neuropathy, presenting to a community hospital in a major metropolitan area with 10 days nausea and vomiting and a benign abdominal exam. While the patient was admitted for hyperglycemia, he was subsequently found to have severe GC requiring urgent surgical intervention.
Background: Medical students must be able to suture competently upon graduation. To learn suturing technique, students must have access to practice materials. The purpose of this pilot study was to develop a novel suturing trainer and to evaluate its ability to provide realistic and accessible suturing practice. A cohort of senior students at one institution compared the device with standard suture-training media (porcine feet and sponges). Methods: Using 3D printing and silicone casting, a novel suturing Using 3D printing technology, we designed a silicone training device that could provide students with a simple and accessible tool for suturing practice
Background:
Despite extensive literature on the classification and management of nasal septal deviation (NSD) for preoperative planning, standardized objective measures to evaluate the NSD severity remains challenging. In this study, we quantitatively analyzed NSD to determine the most predictive two-dimensional (2D) computed tomography (CT)-landmark for overall three-dimensional (3D) septal morphology derived from nasal airway segmentation.
Methods:
A retrospective study was conducted at a large academic center. One hundred four patients who underwent CT scans of the face were selected from a computer imaging database. Demographic variables were screened to ensure an equal number of men and women in different age groups. Digital Imaging and Communications in Medicine files were imported for 3D nasal cavity segmentation using 3D Slicer software. A volumetric analysis was performed to determine 3D NSD ratios. These values were compared to previously reported methods of obtaining objective 2D NSD measures using OsiriX and MATLAB software. Maximum deviation values were calculated using OsiriX, while the root mean square values were retrieved using MATLAB. Deviation area and curve to line ratios were both quantified using OsiriX and MATLAB.
Results:
The data set consisted of 52 men and 52 women patients aged 20 to 100 years (mean = 58 years, standard deviation = 23 years). There was a strong correlation between 3D NSD ratio and maximum deviation (r = 0.789, P < 0.001) and deviation area (r = 0.775, P < 0.001). Deviation area (r = 0.563, P < 0.001), root mean square (r = 0.594, P < 0.001), and curve to line ratio (r = 0.470, P < 0.001) had a positive correlation of moderate strength. The curve to line ratio was not significant (r = 0.019, P = 0.85).
Conclusions:
The 2D CT-based NSD landmarks maximum deviation and deviation area were the most predictive of the severity of NSD from 3D nasal cavity segmentation. We present a robust open-source method that may be useful in predicting the severity of NSD in CT images.
There is a significant gender gap in research conducted by women in plastic surgery. Previous work has not explored female authorship trends in cosmetic plastic surgery. We asked how authorship trends in cosmetic plastic surgery compare with those in plastic surgery overall, over the last 10 years. All the articles published in Journal of Plastic Reconstructive and Aesthetic Surgery (JPRAS), Facial Plastic Surgery and Aesthetic Medicine (JAMA facial plastics), and Aesthetic Surgery Journal. (ASJ) in 2009, 2014, and 2019 were retrieved. The gender of the first and last author was determined. In addition, article type and total number of authors were extracted. Chi-square or Fisher exact test were performed to determine differences between groups Linear regression models were used to investigate whether total number of authors, or female last authorship predicted female first authorship. A total of 4358 articles were reviewed. Of these, 16.6% (n = 723) were published by a female first and/or last author. Percent of female first and/or last author increased with time, from only 12.2% in 2008, to 15.9% in 2014, reaching 21.7% in 2019. A total of 25% (n = 181) of randomized controlled trials were published by a female first and/or last author compared with only 14% (n = 440) of case studies. Female first and last authorship both increased across the 10-year study period, but there were consistently more female first authors than female last authors in all 3 surveyed years ( P < .001). There was an 86% increased chance of female first authorship if the last author was also female ( P < .001), and a 7% increased likelihood of female first authorship ( P = .002). Women have a lower representation in the cosmetic plastic surgery literature than men. This gender disparity gap, however, is decreasing. While encouraging, opportunities for improvement remain.
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