The use of Fibrin Sealants in Reducing Drain Output in Abdominoplasty: Is it Useful?

Background: Abdominoplasty is a common surgical procedure in which excess abdominal skin and fat are reduced to improve body contouring. Fibrin sealant has been proposed to reduce postsurgical bleeding and exudation. In this study, we evaluated whether there was a significant statistical difference in surgical output between the use of fibrin glue and its nonuse in abdominoplasty surgery, specifically in reducing bleeding and exudation.

Parecoxib decreases cellular growth and Bcl-2 protein levels in primary cultures of keloid fibroblasts.

Keloids seem to overexpress cyclo-oxygenase-2 (COX-2), suggesting a role in its deregulated pathway in inducing an altered epithelial-mesenchymal interaction, which may be responsible for the overgrowth of dermal components resulting in scars or keloid lesions. This study aimed to evaluate the effect of Parecoxib, a COX-2 inhibitor, on cell growth in fibroblast primary cultures obtained from human keloid tissues. Tissue explants were obtained from patients who underwent intralesional excision of untreated keloids; central fractions were isolated from keloid tissues and used for establishing distinct primary cultures.

Tuberous Breast Management: A Review of Literature and Novel Technique Refinements.

Unlabelled: The tuberous breast is a rare malformation that can affect psychosocial well-being in young women. Its management represents a great challenge to plastic surgeons. Many surgical procedures have been described to correct different grades of tuberous breast deformity (TBD).

Mondor's disease as a complication in breast surgery in a male patient. The first ever reported case in literature.

Mondor's disease (MD) is an uncommon clinical condition characterized by thrombophlebitis of the superficial veins of the anterolateral thoracoabdominal wall. In this paper we present the first ever reported case of Mondor's disease in male patient after surgical correction of gynecomastia with liposuction assisted skin sparing adenectomy.

The Impact of Direct Oral Anticoagulant Prophylaxis for Thromboembolism in Thrombophilic Patients Undergoing Abdominoplastic Surgery.

Congenital or acquired thrombophilia is observed in 10-15% of the general population; therefore, careful screening is carried out in patients at higher risk of venous thrombo-embolism (VTE). High risk of VTE is a contraindication in patients undergoing abdominoplasty. We evaluated rivaroxaban, an oral Xa inhibitor, with enoxaparin, a subcutaneously low molecular weight heparin (LMWH), in 48 female patients with documented thrombophilia, undergoing thrombo-prophylaxis after abdominoplasty.

Postural Changes After Abdominoplasty in Morbid Obese Patients.

Background: In the multidisciplinary treatment of obesity, the role of a plastic surgeon is to remove the excess of skin after weight loss to obtain cosmetic, functional, and psychological benefits. Obesity modifies body geometry, increases the mass of different segments, and imposes functional limitations in life activities that may predispose the obese to injury. The authors evaluated the postural conditions of obese patients, before and 12 months after surgery.

Management of complication after breast augmentation with methacrylate.

Introduction: Several alloplastic biomaterials are available for injection to the breast, nevertheless not all of them are approved for biomedical use. Although in North America and Western Europe experience with synthetic biomaterials for breast augmentation is very limited, migratory streams might expose physicians worldwide to manage the related complications of these procedures. The aim of this study was to share with other surgeons the case of a patient presenting complications after breast augmentation with an unknown synthetic substance containing methacrylate.

Combined epigastric hernia repair and mini-abdominoplasty. Case report.

The objectives of abdominal hernia repair are to restore the structural integrity of the abdominal wall. Current techniques include primary closure, staged repair and the use of prosthetic materials. Techniques for mini-abdominoplasty include the use of the transverse lower abdominal incision and the resection of excess skin.

Expanded Flaps in Surgical Treatment of Pressure Sores: Our Experience for 25 Years.

Background: Because the ischial region is the main weight-bearing area in sitting, it is one of the areas most frequently affected by pressure ulcers in paraplegic patients resuming the sitting position during the subacute and chronic stages. The techniques described to date have not been able to reduce the high rates of recurrence and flap dehiscence. Other groups have described successful tissue expansion in the treatment of pressure ulcers, but to date, the long-term results of the procedure have not been reported.

[Using the Mini-Mental State Examination (MMSE) for preliminary assessment of cognitive impairment in subjects exposed to air pollution with particulate matter].

Epidemiologic and clinical studies have linked elevated concentrations of particulate matter to adverse health effects. In particular, has been demonstrated an association between UFPs exposure and occurrence of acute respiratory infections, lung cancer, chronic chronic obstructive pulmonary diseases and cardiovascular diseases. Recently, the exposure to particulate air pollution has been linked to cognitive decline.

Coverage of the neurovascular unit of the fingertip using a reverse homodigital dorsal flap.

The exposure of bone, tendons, vessels, and nerves in a digital defect is one of the most frequent and severe problems to solve in hand surgery and current approaches are still disappointing. We show the use of an homodigital adipofascial flap taken from the same finger for covering the pulpar defect in a one-step surgical technique able to preserve the digital artery.

Risk factors and acute ischemic stroke subtypes.

Background: Acute ischemic stroke (AIS) is influenced by gender, age, and the brain site affected. Better characterization of AIS is necessary for improving guidelines, prevention, and destination of resources.

Methods: Demographics, prestroke conditions, etiology, subtypes, specific hospital outcome, clinical and laboratory parameters, and mortality rates were prospectively registered in 105 southern Italian patients.

A useful method to overcome the difficulties of applying silicone gel sheet on irregular surfaces.

To date, silicone gel and silicone occlusive plates are the most useful and effective treatment options for hypertrophic scars (surgical and traumatic). Use of silicone sheeting has also been demonstrated to be effective in the treatment of minor keloids in association with corticosteroid intralesional infiltration. In our practice, we encountered four problems: maceration, rashes, pruritus and infection.

Blood biomarkers role in acute ischemic stroke patients: higher is worse or better?

Background: Thrombolytic therapy (TT) for acute ischemic stroke (AIS) can provoke bleeding's complication depending on the ischemic lesion (IL) dimension. Inflammation involved in the setting of acute ischaemic stroke, is associated with infarct size. We aimed to study the independent correlation and association between clinical panel of routinely identified biomarkers, including inflammatory parameters, and cerebral IL dimension and site.

Clinical and histologic effects from CO2 laser treatment of keloids.

Keloids and hypertrophic scars are abnormal responses to wound healing. In general, keloids exhibit a proliferative growth beyond the margins of the scar and remain persistent; while hypertrophic scars are contained to the original wound and may regress over time. In particular, keloid formation is one of the most challenging clinical problems, with increasing frequency in surgical practice.

Retrospective and observational study to assess the efficacy of citicoline in elderly patients suffering from stupor related to complex geriatric syndrome.

A significant percentage of elderly subjects (50%-80%) suffering from sub-acute ischemic cerebrovascular disease, with or without moderate or severe cognitive memory decline and with or without associated behavioral and psychological symptoms, shows a complex syndrome. This syndrome is related to the progressive impairment of health conditions and/or stressing events (ie, hospitalization), characterized by confusion and/or stupor, which are consequently difficult to manage and require a great deal of care. Geriatric patients often suffer from multiple chronic illnesses, may take numerous medications daily, exhibit clinical instability, and may experience worsening of medical conditions following cerebral ischemic events and thus have an increased risk of disability and mortality.

Gluteal augmentation with cryopreserved fat.

Gluteal augmentation with autologous fat is becoming a standard ancillary procedure for sculpting the buttock area. The high rate of resorption due to aggressive harvesting techniques or inadequate injection procedures often leads to repeated treatments. Currently, several techniques for storing fat by controlled freezing and thawing procedures can guarantee a high rate of cell viability, similar to that obtained with fresh tissue.

Bariatric surgery reduces oxidative stress by blunting 24-h acute glucose fluctuations in type 2 diabetic obese patients.

Objective: We evaluated the efficacy of malabsorptive bariatric surgery on daily blood glucose fluctuations and oxidative stress in type 2 diabetic obese patients.

Research Design And Methods: The 48-h continuous subcutaneous glucose monitoring was assessed in type 2 diabetic patients before and 1 month after biliopancreatic diversion (BPD) (n = 36), or after diet-induced equivalent weight loss (n = 20). The mean amplitude of glycemic excursions and oxidative stress (nitrotyrosine) were evaluated during continuous subcutaneous glucose monitoring.

Role of subcutaneous abdominal fat on cardiac function and proinflammatory cytokines in premenopausal obese women.

The role of surgically removing subcutaneous fat by abdominoplasty on circulating inflammatory markers and myocardial dysfunction, evaluated by myocardial performance index (MPI), were investigated. Twenty volunteers submitted to the abdominoplasty (abdominoplasty group), and other 28 women treated by hypocaloric diet (diet group) were evaluated. Echocardiographic parameters of MPI, circulating levels of tumor necrosis factor (TNF)-alpha and interleukin (IL)-6, were performed at baseline and 2 months later.

Differential expression of cyclooxygenases in hypertrophic scar and keloid tissues.

Hypertrophic scar (HS) and keloid (KL) are two forms of an abnormal cutaneous scarring process, mainly characterized by excessive extracellular matrix deposition and fibroblast proliferation. Despite the increased understanding of the molecular and cellular events leading to HS and KL, the pathogenesis of these lesions remains poorly understood. A pivotal role in the formation of abnormal scars has been ascribed to transforming growth factor-beta, whose activity appears to be mediated through a link with pathways acting via cyclooxygenases (COX-1 and COX-2).

Modification of cysteinyl leukotriene receptors expression in capsular contracture: follow-up study and definitive results.

Periprosthetic capsular contracture represents a specific iatrogenic phenomenon with different side effects. Recently, interesting data have disclosed a potential role of leukotrienes as important mediators of inflammation in the reactivation process of capsular contracture. Some preliminary studies have assessed the efficacy of leukotriene antagonists in the prevention and treatment of capsular contracture.

Effects of vildagliptin twice daily vs. sitagliptin once daily on 24-hour acute glucose fluctuations.

There is increasing evidence that glycemic disorders such as rapid glucose fluctuations over a daily period might play an important role on diabetic complications. We evaluated the efficacy of sitagliptin 100 mg once daily vs. vildagliptin 50 mg twice daily on daily blood glucose fluctuations in patients with type 2 diabetes that was inadequately controlled by metformin.

Evidence for anti-inflammatory effects of combined administration of vitamin E and C in older persons with impaired fasting glucose: impact on insulin action.

Objective: Vitamin E and C given separately improve insulin sensitivity due to an inhibitory effect on oxidative stress and inflammation, however their combined effect on glucose control and inflammation is unknown. To investigate combined effect of Vitamin E and C in elderly with Impaired Fasting Glucose (IFG) on insulin action and substrate oxidation.

Design: Controlled-trial administration of Vitamin E (1000 mg/day) and Vitamin C (1000 UI/day) for four weeks.

Arterial stiffness and cognition in elderly persons with impaired glucose tolerance and microalbuminuria.

Background: Cognitive decline that occurs frequently in impaired glucose tolerance (IGT) may be largely due to endothelial dysfunction. We assessed: (i) the relationships between impact of urinary albumin excretion rate (UAER), as marker of generalized endothelial dysfunction, and cognition; (ii) if cognitive decline could be explained by arterial stiffening using pulse wave velocity (PWV).

Methods: One hundred forty older patients (age range 70-85 years) with IGT and no dementia were selected.

Relationship of calcification of atherosclerotic plaque and arterial stiffness to bone mineral density and osteoprotegerin in postmenopausal women referred for osteoporosis screening.

Arterial calcification leading to increased arterial stiffness, a powerful risk factor for cardiovascular disease, may underlie the association of osteoporosis with cardiovascular disease in postmenopausal women. Osteoprotegerin (OPG), an indirect inhibitor of osteoclastogenesis, may be involved in arterial calcification. We examined relationships between calcification of subclinical atherosclerotic plaque and arterial stiffness with bone mineral density (BMD) and OPG in a group of 54 postmenopausal women referred for routine osteoporosis screening by dual-energy X-ray absorptiometric scanning of the lumbar spine and hip.