Health System Factors Influencing the Integration of Pre-Exposure Prophylaxis into Antenatal and Postnatal Clinic Services in Cape Town, South Africa.

Introduction: Oral pre-exposure prophylaxis (PrEP) is an effective and safe option to prevent HIV acquisition and vertical HIV transmission in pregnant and breastfeeding women. Understanding health system factors influencing the integration of PrEP into care for pregnant and breastfeeding women is key to increasing access. We explored managers' and health care workers' (HCWs) experiences with integrating PrEP into antenatal care and postnatal care services in primary health care clinics in Cape Town, South Africa.

Risk Ladder, Table, or Bulleted List? Identifying Formats That Effectively Communicate Personalized Risk and Risk Reduction Information for Multiple Diseases.

Background: Personalized medicine may increase the amount of probabilistic information patients encounter. Little guidance exists about communicating risk for multiple diseases simultaneously or about communicating how changes in risk factors affect risk (hereafter "risk reduction").

Purpose: To determine how to communicate personalized risk and risk reduction information for up to 5 diseases associated with insufficient physical activity in a way laypeople can understand and that increases intentions.

Automatic detection of perforators for microsurgical reconstruction.

The deep inferior epigastric perforator (DIEP) is the most commonly used free flap in mastectomy reconstruction. Preoperative imaging techniques are routinely used to detect location, diameter and course of perforators, with direct intervention from the imaging team, who subsequently draw a chart that will help surgeons choosing the best vascular support for the reconstruction. In this work, the feasibility of using a computer software to support the preoperative planning of 40 patients proposed for breast reconstruction with a DIEP flap is evaluated for the first time.

The Evolution of Breast Reduction Publications: A Bibliometric Analysis.

Objective: This study aims to make a bibliometric analysis of the studies on breast reduction (BR) between the years 1980 and 2016 and identify important studies through trend topics as well as active authors, countries, universities, scientific journals, and citation and co-citation analyses about BR.

Background: Although BR looks like one of the cosmetic surgeries performed in order to restore the woman's appearance, in fact it is a reconstructive surgery that eliminates back pain, stance disorder, headache, shoulder pain, back and cervical disk hernia, difficulty in breathing, hollowness caused by bra straps, hygiene problems under breasts (e.g.

Current trends in breast reduction.

Results of our study describe the long term effects of reduction mammaplasty. Many women with excessively small or large breasts have an altered personal self-image and often suffer from low self-esteem and other psychological stresses. This procedure is designed to reduce and reshape large breasts, and since the size, shape, and symmetry of a woman's breasts can have a profound effect on her mental and physical well-being it is important to observe the patient's long-term outcome.

The Hall-Findlay mammaplasty pattern for skin-sparing mastectomy: case report.

We present an application of the Hall-Findlay mammaplasty skin pattern for skin-sparing mastectomy (SSM). This is a simplified vertical reduction mammaplasty. Vertical reduction mammaplasty is the procedure advised for patients with moderator or large ptotic breasts, who wish to have a simultaneous contra-lateral breast reduction/mastopexy at the time of SSM for cancer or prophylactic mastectomy.

Pregnancy and optimal care of HIV-infected patients.

Human immunodeficiency virus (HIV) infection during pregnancy is a condition that requires multidisciplinary care. Care must be rendered that is appropriate for both the mother and the fetus. Prevention of mother-to-child transmission of HIV is of paramount concern.

The versatile helium balloon mastopexy.

Background: Mastopexy is a challenging procedure, particularly with the trend toward procedures with lesser scarring. When combined with breast augmentation, the risk of complications is greater than with either component alone.

Objective: An attempt was made to simplify mastopexy, giving a "what you see is what you get" result before any surgical bridges are crossed while minimizing disruption of the breast gland and its circulation.

Understanding modern breast reduction techniques with a simplified approach.

Objective: The purpose of this study was to analyse the geometrical principles of breast reduction, to propose a classification of reduction mammaplasty techniques and to show a simplified approach based on the authors experience.

Methods: A thorough analysis of the geometrical differences between the normal and enlarged breast was performed. As a result of this analysis, the concept of separate management of the skin and gland for breast reduction was used as a method to classify the different techniques.

Breast reduction: modified "Lejour technique" in 500 large breasts.

Background: The "minimal scar technique" for breast reduction, developed by Marchac, Lassus, and Lejour, has become an increasingly practiced alternative to standard operative procedures.

Methods: The authors introduced the modified "Lejour technique" in nearly 500 breast reductions in 250 overweight patients (adipose breasts) with a resection weight of more than 700 g. Their technique is a step-wise modification of the following procedures, resulting from their experience with complications and outcomes.

Refinements of vertical scar mammaplasty: circumvertical skin excision design with limited inferior pole subdermal undermining and liposculpture of the inframammary crease.

Vertical scar mammaplasty, first described by Lötsch in 1923 and Dartigues in 1924 for mastopexy, was extended later to breast reduction by Arié in 1957. It was otherwise lost to surgical history until Lassus began experimenting with it in 1964. It then was extended by Marchac and de Olarte, finally to be popularized by Lejour.

Simplifying the vertical reduction mammaplasty.

The vertical reduction mammaplasty is an evolving technique. Its proponents report significantly decreased scarring, better breast shape, and more stable results compared with the standard inverted-T method, but the learning curve is long and cosmetic outcomes can be inconsistent. Many surgeons have experimented with the vertical closure before returning to methods more familiar to them.

Innovations to the vertical reduction mammaplasty: making the transition.

The vertical reduction mammaplasty can be challenging to learn. In addition, first attempts to perform the vertical reduction mammaplasty can lead to inconsistent aesthetic results. The authors describe their transition from a traditional inverted-T reduction mammaplasty to a modified vertical reduction mammaplasty based on a technique described by Elizabeth Hall-Findlay.

Simplified antiviral prophylaxis with or and without artificial feeding to reduce mother-to-child transmission of HIV in low and middle income countries: modelling positive and negative impact on child survival.

Background: Antiviral prophylaxis is recommended for HIV positive mothers to prevent mother-to-child transmission of HIV. To date UNAIDS and WHO policy has been based on a study in Thailand which showed a reduction in transmission by half with short course AZT (Zidovudine) treatment together with artificial feeding. We modelled the possible positive and negative effects on child deaths in low and middle resource developing country settings of two interventions to reduce mother to child transmission (MTCT) of HIV: antenatal testing, short-course antivirals (zidovudine or nevirapine), firstly with and then without artificial feeding.

Perinatal Transmission of HIV: Recognition and Treatment Interventions.

Great strides have been made in the fight against vertical transmission of HIV-1. Improved understanding of mechanisms and timing of transmission of HIV-1 from mother to child have led to the development of effective intervention strategies that have reduced transmission rates to unprecedented low levels, below 2% in developed countries. New reports using shortened, more affordable courses of antiretrovirals prenatally or at the time of delivery have also shown a significant reduction in transmission, over 50% in studies conducted in the developing world.

A simplified vertical reduction mammaplasty: shortening the learning curve.

Although the vertical reduction mammaplasty is effective in reducing scarring, the technique has not achieved widespread acceptance in North America. There are several reasons for this. Some believe that the vertical reduction mammaplasty is only applicable to smaller breast reductions and that the learning curve is difficult.