Six-year experience of oncoplastic volume replacement using local perforator flaps.

Local perforator flaps may be utilised to correct volume defects after breast-conserving surgery (BCS), improving the cosmetic outcome and avoiding the need for contralateral symmetrising surgery. The aims of this study were to assess longer term oncological outcomes following local perforator flap reconstruction, and to demonstrate the learning curve associated with incorporating such techniques within routine clinical practice. We report a consecutive case series of 116 local perforator flaps performed between January 2014 and May 2020.

The Use of Local Perforator Flaps in Delayed or Secondary Breast Reconstruction.

Local perforator flaps are used as immediate volume replacement techniques in breast conserving surgery. Here, we describe a case series of local perforator flaps used in the delayed setting to correct defects following previous breast surgery, including previous breast conservation surgery or mastectomy with reconstruction. All cases were performed in a tertiary referral breast unit between 2014 and 2020.

The use of venous anastomotic flow couplers to monitor buried free DIEP flap reconstructions following nipple-sparing mastectomy.

Nipple sparing mastectomy with free tissue transfer for breast reconstruction offers excellent aesthetic outcomes but poses a challenge in monitoring the buried flap. Venous anastomotic flow couplers directly monitor buried flaps without the need for monitoring skin paddles. In a two year period we used the Synovis GEM™ flow coupler on 24 DIEP flaps.

Clinical predictors of involuntary detention among voluntary inpatients in St Patrick's University Hospital (SPUH).

Background: Few studies have described clinical characteristics of patients subject to an involuntary detention in an Irish context. The Irish Mental Health Act 2001 makes provision under Section 23(1), whereby a person who has voluntary admission status can be detained. Aims This study aimed to describe all involuntary admissions to St Patrick's University Hospital (SPUH) (2011-2013) and to evaluate clinical characteristics of voluntary patients who underwent Mental Health Act assessment during 2011 to determine differences in those who had involuntary admission orders completed and those who did not.

The impact of a change in prescribing policy on antipsychotic prescribing in a general adult psychiatric hospital.

Objectives: To examine the impact of a change in local prescribing policy on the adherence to evidence-based prescribing guidelines for antipsychotic medication in a general adult psychiatric hospital.

Methods: All adult in-patients had their clinical record and medication sheet reviewed. Antipsychotic prescribed, dose prescribed and documented indications for prescribing were recorded.

Perivascular cells in a skin graft are rapidly repopulated by host cells.

Survival of grafted tissues is dependent upon revascularisation. This study investigated revascularisation in a murine skin graft model, using two methods. The first involved 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine (DiI) labelling of the wound bed, prior to replacing the skin graft, to allow tracking of host cells into the grafts.

The microcirculation in acute murine cutaneous incisional wounds shows a spatial and temporal variation in the functionality of vessels.

A mouse perfusion model using fluorescently labeled dextran has been developed to investigate the functionality of blood vessels during cutaneous wound healing. By immunostaining cryostat sections of perfused wounds with antibodies that identify vessels, we were able to assess their functionality. There was an increase in the proportion of CD31(+)-perfused vessels in all wound regions with time, although the vessels of the wound margins and superficial granulation tissue (GT) took the longest to become perfused.

Quantification of total and perfused blood vessels in murine skin autografts using a fluorescent double-labeling technique.

Background: Two theories exist regarding the revascularization of skin autografts: direct anastomosis between graft vessels and bed vessels, and ingrowth of bed vessels (angiogenesis) into the graft. This study characterizes revascularization, spatially and chronologically, in a murine skin autograft model using a double-labeling technique.

Methods: Full-thickness (1 cm2) skin grafts were performed on adult male C57/Bl6 mice.

Unreality symptoms and volumetric measures of Heschl's gyrus and planum temporal in first-episode psychosis.

Background: Schizophrenia may involve dysfunction to primary auditory, speech, and language processes governed by the superior temporal gyrus (STG). These processes are implicated in hallucinations, delusions, and thought disorder. The current study explored the relationship between unreality symptoms (hallucinations and delusions) and specific STG substructures, including Heschl's gyrus (HG) and planum temporale (PT).

Volumetric neural correlates of antisaccade eye movements in first-episode psychosis.

Objective: The authors investigated the structural brain correlates of antisaccade performance.

Method: Magnetic resonance imaging was used to measure the volumes of the prefrontal, premotor, sensorimotor, and occipitoparietal cortices as well as the caudate, thalamus, cerebellar vermis, and cerebrum in 20 first-episode psychosis patients and 18 healthy comparison subjects. Antisaccades were recorded by using infrared oculography.

An anatomical study of the superficial inferior epigastric vessels in humans.

The lower abdominal skin and fat has become a standard for breast reconstruction in terms of skin texture, suppleness and colour. Concerns regarding donor site morbidity related to the harvest of rectus abdominis musculocutaneous flap, based on the deep inferior epigastric vessels, have turned attention towards alternative options. The superficial inferior epigastric artery (SIEA) flap is a fasciocutaneous flap that has been used for reconstruction of the breast, as well as head, neck and limb defects.

Selective deficit of hippocampal N-acetylaspartate in antipsychotic-naive patients with schizophrenia.

Background: Studies using proton magnetic resonance spectroscopy in schizophrenia have demonstrated abnormality of N-acetylaspartate but are confounded by the effects of phase of illness and medication. There is mounting evidence that antipsychotic medication influences N-acetylaspartate.

Methods: A group of first-episode patients who had received no, or minimal, antipsychotic medication was examined at baseline and after 3 months treatment.

Temporal lobe abnormalities in first-episode psychosis.

Objective: The nature and time course of temporal lobe abnormalities in psychotic illness remain controversial. Confounds include disease chronicity, gender, and handedness. The present study investigated temporal substructures in right-handed male patients experiencing their first episode of psychotic illness.

Magnetic resonance imaging of the thalamus in first-episode psychosis.

Objective: There is some evidence of thalamic abnormalities in schizophrenia. This study investigated thalamic volumes in patients experiencing their first episode of psychosis and nonpsychotic comparison subjects.

Method: Magnetic resonance imaging scans were obtained for 38 patients and 29 comparison subjects.

Third ventricle enlargement and developmental delay in first-episode psychosis: preliminary findings.

Background: Third rather than lateral ventriculomegaly may be a more specific finding in psychosis. The relevance of ventricular abnormality remains unclear.

Aims: To investigate the developmental correlates of ventricular enlargement.

Experience of caregiving: relatives of people experiencing a first episode of psychosis.

Background: There has been relatively little research on caregivers of people experiencing their first episode of psychosis.

Aims: To investigate dimensions of caregiving and morbidity in caregivers of people with first-episode psychosis.

Method: Caregivers of 40 people with first-episode psychosis were interviewed at home about their experience of caregiving, coping strategies and distress.

Features of structural brain abnormality detected in first-episode psychosis.

Objective: Structural magnetic resonance imaging (MRI) studies that focus on first-episode psychosis avoid some common confounds, such as chronicity of illness, treatment effects, and long-term substance abuse. However, such studies may select subjects with poor short-term treatment response or outcome. In this study, the authors focus on structural brain abnormalities in never or minimally treated patients who underwent MRI scanning early in their first episode of psychosis.

Should an appendix that looks 'normal' be removed at diagnostic laparoscopy for acute right iliac fossa pain?

Objective: To find out whether the removal of the appendix from patients in whom laparoscopy for acute right iliac fossa pain shows no abnormality is justified to avoid the risk of missing acute appendicitis.

Patients: The records of patients who, between 1990 and 1997 had emergency laparoscopy for acute right iliac fossa pain were reviewed. Only those in whom laparoscopy had shown no abnormality and had not had the appendix removed were included in the study.