Dermatological uses of rice products: Trend or true?

Background: Rice has been used for cosmetic purposes for centuries and its benefits have been translated into modern-day skin careproducts.

Methods: Pubmed and google were searched with the terms "skin care" and "cosmetics" in conjunction with the words "rice", "rice bran", and "fermented rice bran". Resulting articles were analysed for potential benefits of ingredients contained within rice for skin care and summarised.

A Rare Clinical Presentation of Metastatic Crohn's Disease.

A 31-year-old female with a history of systemic lupus erythematous, IgA nephropathy, and psoriasis presented with a one-month history of a painful, pruritic rash under the bilateral breasts and in the genital region. Cutaneous examination revealed a large, tender ulcer under the left breast with a shiny erythematous base and peripheral hypertrophic changes. Small ulcers were present on the bilateral inguinal folds, and the labia majora were edematous with multiple erythematous papules.

Prepectoral Breast Reconstruction.

Prepectoral breast reconstruction was first done in the early 1960s; however, while initial results were promising, high complication rates led surgeons to move toward submuscular implant placement. We soon came to find that submuscular implant placement was not without its own set of drawbacks. Surgeons have since revisited the efficacy of prepectoral breast reconstruction in light of new surgical and technological advances.

What are the ethical and legal considerations when your patient refuses the standard of care?

In medical practice, physicians are sometimes faced with patients who reject the gold-standard treatment for a condition. In this hypothetical clinical scenario, we present the case of a patient who refuses Mohs micrographic surgery for management of infiltrative basal cell carcinoma and instead requests off-label therapy with imiquimod. We discuss the treating dermatologist's options in response to this patient's request and the ethical considerations surrounding the case.

The Utility of an Open-Access Surgical Simulator to Enhance Surgeon Training.

Background: Smile Train, an international children's charity committed to improving cleft care around the world, empowers local medical professionals in developing countries to provide quality comprehensive cleft care in their own communities. As part of their sustainable model, Smile Train developed a web-based, interactive virtual simulator to improve surgical training of cleft procedures for surgeons around the world, replicating the anatomical and technical steps involved in cleft surgery. This study evaluated the simulator as a tool for enhancing surgical training.

A systematic review of complications in prepectoral breast reconstruction.

The use of implants for breast reconstruction began over four decades ago, with implants initially placed in the prepectoral space. Concerns arose regarding the high incidence of capsular contracture and complication rates. With the introduction of acellular dermal matrix (ADM), plastic surgeons are again considering the advantages of prepectoral implant placement.

A review of N-acetylcysteine in the treatment of grooming disorders.

Background: Pathologic grooming disorders can lead to clinically significant distress and functional impairment. Studies on treatment of these disorders with selective serotonin reuptake inhibitors (SSRIs) and anticonvulsants have led to inconsistent findings. N-acetylcysteine (NAC) has shown promise in treatment of obsessive-compulsive and related disorders.

Speech Outcomes After LeFort I Advancement Among Cleft Lip and Palate Patients.

Background: Velopharyngeal insufficiency (VPI) results from incomplete closure of the velopharyngeal (VP) sphincter with oral pressure consonants during speech. Maxillary hypoplasia is common among cleft children and often requires LeFort I advancement. This results in anterior movement of the soft palate with the bony maxillary segment.

A Sustainable and Scalable Approach to the Provision of Cleft Care: A Focus on Safety and Quality.

Background: A global health model based on partnering with local hospitals and surgical teams, providing education and training for local providers, and mandating adherence to safety and quality standards to ensure safe surgery and anesthesia care can build local surgical capacity and strengthen existing health care systems in low- and middle-income countries. Smile Train uses this sustainable partnership model to provide responsible humanitarian aid while maintaining a bidirectional exchange with its international partners.

Methods: A voluntary online survey is administered annually to Smile Train's global partners.

Medical Consultation Experience Questionnaire: Assessing perceived alliance and experienced confusion during medical consultations.

The Medical Consultation Experience Questionnaire (MCEQ) is a new, brief self-report instrument that can be used with both adult patients and parents of child patients to assess two dimensions of people's experiences interacting with medical practitioners: Alliance and Confusion. In contrast with existing measures, the MCEQ was expected to provide good discrimination across a full range of experience levels and to assess two distinct dimensions of experience with good factor validity. It was developed in a series of 7 preliminary studies (with 758 participants) and tested in 3 subsequent validation studies, which are the focus of the present report.

Safety Outcomes in Endoscopic Versus Open Repair of Metopic Craniosynostosis.

Background: Premature fusion of the metopic suture leads to a range of clinical presentations, with more severe patients presenting characteristically with trigonocephaly. Endoscopic-assisted correction of craniosynostosis is emerging as an alternative to the gold-standard open cranial vault remodeling. While there are several documented benefits of endoscopic correction, the management of craniosynostosis varies widely in the literature with little consensus as to the preferred timing and surgical technique for repair.

Insurance Appeals for Pediatric Reconstructive Surgery: A Micro Cost Analysis and How-to Guide.

Background: When insurance coverage for pediatric reconstructive procedures is denied, a stressful and time-consuming appeals process ensues. This article discusses the results of a micro cost analysis performed to better understand the time and monetary burden that the insurance process places on our clinic and families. We also advise plastic surgeons on how to appeal insurance denials for necessary reconstructive procedures.

Shared Medical Appointments for Adolescent Breast Reduction.

Adolescents with macromastia face serious physical, emotional, and social burdens because of their large breast size. Studies have shown that reduction mammoplasty results in improvement in physical symptoms and quality of life for these patients. Shared medical appointments (SMAs), defined as individual patient-physician encounters that occur in a group setting, have been successfully applied to clinics for adult patients seeking breast reduction for this condition.

Differences in the Management of Pediatric Facial Trauma.

Craniofacial trauma is common in the pediatric population, with most cases limited to soft tissue and dentoalveolar injury. Although facial fractures are relatively rare in children compared with adults, they are often associated with severe injury and cause significant morbidity and disability. Initial evaluation of a child with facial trauma generally involves stabilizing the patient and identifying any severe concomitant injuries before diagnosing and managing facial injuries.

Frontal Sinus Fractures.

The frontal bone serves a protective role, representing the transition between the facial skeleton and the cranium. Within its enclosure, the frontal sinus lies adjacent to many important intracranial structures, and injury to this region has severe complications if not properly managed. Historically, the goals of frontal sinus fracture management have been to best prevent intracranial complications with invasive procedures, but a recent shift favoring conservative management now aims to preserve the form and function of the frontal sinus and its outflow tract.

Soft Tissue Management in Facial Trauma.

The management of soft tissue injury after facial trauma poses unique challenges to the plastic surgeon, given the specialized nature of facial tissue and the aesthetic importance of the face. The general principles of trauma management and wound care are applied in all cases. The management of severe injuries to the face is discussed in relation to the location and the mechanism of injury.

Pediatric Blepharoptosis.

Congenital blepharoptosis, caused by levator muscle dysgenesis, presents at birth and may lead to disturbed visual development and function. Other causes of ptosis in pediatric patients can be myogenic, neurogenic, mechanical, or traumatic. Timely correction is, therefore, critical, and careful preoperative planning and intraoperative considerations are crucial to achieve optimal outcomes and minimize potential complications.

Orbital Decompression for Thyroid Eye Disease.

Although most cases of thyroid eye disease (TED) can be managed medically, some refractory or severe cases are treated surgically with orbital decompression. Due to a lack of randomized controlled trials comparing surgical techniques for orbital decompression, none have been deemed superior. Thus, each case of TED is managed based on patient characteristics and surgeon experience.

Syndactyly Release.

Syndactyly is one of the most common congenital hand anomalies treated by pediatric plastic surgeons. Established principles of syndactyly separation dictate the timing and order of syndactyly release, with the goals of surgery being the creation of an anatomically normal webspace, tension-free closure of soft tissue, and return of function to the fingers. Numerous surgical methods have been described, many of which involve the use of local flaps to reconstruct the commissure and full-thickness skin grafts for coverage of raw areas.

Tissue Expansion in Children.

Tissue expansion is a well-established surgical method that has been creatively applied to the management of many congenital and acquired pediatric conditions, including the removal of giant congenital melanocytic nevi and the separation of conjoined twins. Careful preoperative planning and patient follow-up are required to achieve the proper results and minimize complications. Special considerations for pediatric patients are present during each step of the process, from patient selection to postoperative care.