Postoperative Radiologic Imaging in Secondary Alveolar Bone Grafting for Cleft Lip and Palate: A Systematic Review and Meta-Analysis.

Introduction: Radiographs (XRs), computed tomography (CT) scans, and cone-beam CT (CBCT) scans are utilized for assessment of secondary alveolar bone graft (SABG) in patients with cleft lip and palate (CLP). However, the optimal choice for imaging modality remains unclear. This study compares the image fidelity and safety profile for XR, CT, and CBCT in the assessment of patients with CLP who have undergone SABG.

Insurance coverage during transitions: Evidence from Medicaid automatic enrollment for children receiving supplemental security income.

Objectives: To analyze relationships between Medicaid automatic enrollment for child Supplemental Security Income (SSI) recipients and health insurance coverage during transitions.

Data Sources And Study Setting: Medical Expenditure Panel Study, 2000-2020 and National Survey for Children with Special Health Care Needs, 2001-2010.

Study Design: Leveraging variation in SSI-Medicaid automatic enrollment status across regions and over time, we estimate a regression model to quantify associations between automatic enrollment and insurance coverage.

Implementation and Outcome Evaluation of LA DOOR: A Proposition 47-Funded Program in Los Angeles: Cohort 2 Final Evaluation Report.

The Los Angeles Diversion, Outreach, and Opportunities for Recovery (LA DOOR) program is a Proposition 47-funded program designed by the Los Angeles City Attorney's Office (LACA) to provide a comprehensive, health-focused, preventative approach that proactively engages individuals at elevated risk of returning to LACA on a new misdemeanor offense related to substance use, mental illness, or homelessness. This study documents the findings of a process and outcome evaluation of Cohort 2 of the LA DOOR program, covering services provided from January 2020 through February 2023. The goal of this evaluation is to better understand how the LA DOOR program was implemented and examine the effect of the program on various outcomes.

Final Evaluation of LA DOOR: Proposition 47 Grant Program.

The Los Angeles Diversion, Outreach, and Opportunities for Recovery program (LA DOOR) was designed by the Los Angeles City Attorney's Office (LACA) to provide a comprehensive, health-focused, preventative approach that proactively engages individuals at elevated risk of returning to LACA on a new misdemeanor offense related to substance use, mental illness, or homelessness. LA DOOR was funded through the grant program of Proposition 47. Programs funded through Proposition 47 are intended to serve individuals with a history of criminal justice involvement and mental health issues or substance use disorders and to offer mental health services, substance use disorder treatment, and diversion programs for justice-involved individuals.

Exploring the Influence of Gender on Surgical Clerkship Grades and Test Scores: A Single Institution, Multisite Comparison.

Objective: General surgery remains a male-dominated specialty. Women constitute 54% of medical students at the University of Washington, but only 3.4% of full professors within the Department of Surgery.

A Comparative Assessment of Nasal Appearance following Nasoalveolar Molding and Primary Surgical Repair for Treatment of Unilateral Cleft Lip and Palate.

Background: Although many cleft teams have adopted nasoalveolar molding to improve nasal form, few comparative studies have assessed the postoperative benefits of this treatment. Given that reported outcomes have been contradictory and that treatment involves considerable burden to families, the purpose of this study was to assess objective and subjective changes from nasoalveolar molding at approximately 5 years of age.

Methods: All patients with complete unilateral cleft lip and palate who underwent primary cheiloplasty performed by a single surgeon over a 7-year period were reviewed.

An Evaluation of Racial Diversity in Craniofacial Surgery Literature.

Implicit bias can lead to discrimination of certain populations within healthcare. Representation in medical literature is no exception and it is hypothesized that images with lighter skin tone are more prevalent than darker skin tones in craniofacial literature. Clinical photographs and figure graphics from 5 journals were examined for pre-defined years.

Mandibular Foramen Position Predicts Inferior Alveolar Nerve Location After Sagittal Split Osteotomy With a Low Medial Cut.

Purpose: To evaluate whether the distance between the mandibular occlusal plane and mandibular foramen predicts inferior alveolar nerve (IAN) position after the sagittal split osteotomy (SSO) when using a low medial horizontal osteotomy (Posnick's modification).

Methods: This was a retrospective cohort study of patients undergoing bilateral SSOs with the medial osteotomy placed at the level of the mandibular occlusal plane. The primary predictor variable was the vertical distance between the mandibular foramen and mandibular occlusal plane.

Anatomic landmark approach to reconstruction of asymmetric midline cleft lip due to Pai syndrome.

Midline clefts of the upper lip are rare, and it is therefore important that surgeons have access to a methodical approach for when these presentations are encountered. We adapted principles of the anatomic subunit approximation for unilateral cleft lip, to the repair of midline clefts. The overt use of anatomic landmarks to define the repair results in a design that inherently adjusts to varying degrees of clefts and can accommodate asymmetries.

Underrepresentation of Racial Minorities in Breast Surgery Literature: A Call for Increased Diversity and Inclusion.

Objective: In this study, the extent of racial diversity in images of breast-related plastic surgery published literature was investigated to better understand disparities that exist in breast surgery.

Background: The lack of racial diversity in images of skin color in surgery literature can perpetuate implicit bias and stereotypes. Implicit bias can affect the way patients are evaluated, diagnosed, and treated.

Patient Representation in Medical Literature: Are We Appropriately Depicting Diversity?

Background: Racial disparities exist in the accessibility, delivery, and quality of healthcare. Clinical images are central to plastic surgery, but choice of images in the literature is susceptible to implicit biases. The objective of this study was to determine if published images reflect the racial demographic of patients.

Power-Assisted Particulate Bone Grafting Effectively Prevents Osseous Defects After Cranial Vault Reconstruction.

Background: Cranial vault reconstruction (CVR) is the gold standard in the operative treatment of craniosynostosis. Full thickness osseous defects (FTOD) of the calvaria have been observed in 5% to 15% patients after CVR, with higher rates cited in the fronto-orbital advancement (FOA) subset. Particulate bone graft (PBG) harvested manually has been shown to decrease FTOD after FOA from 24% to 5.

Risk Factors for Delayed Referral to a Craniofacial Specialist for Treatment of Craniosynostosis.

Objective: To assess the impact of age at referral on treatment options in craniosynostosis and to identify risk factors for referral delays in this population.

Study Design: A retrospective cohort study was performed on patients with an abnormal head shape diagnosis treated at a single academic medical center between January 1, 2004 and January 1, 2014. Newly diagnosed patients with craniosynostosis were identified and referral patterns were examined.

Nasal Airway Dysfunction in Children with Cleft Lip and Cleft Palate: Results of a Cross-Sectional Population-Based Study, with Anatomical and Surgical Considerations.

Background: The aesthetic aspects of the cleft lip nasal deformity have been appreciated for over a century, but the functional implications have remained largely underappreciated or misunderstood. This study describes the frequency and severity of nasal obstructive symptoms among children with cleft lip and/or cleft palate, addressing the hypotheses that age, cleft type, and severity are associated with the development of nasal obstructive symptoms.

Methods: Children with nonsyndromic cleft lip and/or cleft palate and a comparison group of unaffected children born from 1997 to 2003 were identified through the North Carolina Birth Defects Monitoring Program and birth certificates.

Levothyroxine improves subjective sleepiness in a euthyroid patient with narcolepsy without cataplexy.

Objective: We discuss the use of levothyroxine for excessive daytime sleepiness (EDS) and prolonged nocturnal sleep time in a euthyroid patient with narcolepsy.

Methods: After failure of first-line narcolepsy treatments, a 48-year-old female began levothyroxine (25 mcg/day). After 12 weeks of treatment, the patient was evaluated for improvement in total sleep time and subjective daytime sleepiness assessed by Epworth Sleepiness Scale (ESS).