Dermatofibrosarcoma Protuberans: The Current State of Multidisciplinary Management.

Dermatofibrosarcoma protuberans (DFSP) is a rare, infiltrative, soft tissue tumor. It has a propensity for deep invasion but a low risk for distant metastasis. The classic presentation is a slowly progressive, painless, and erythematous to purpuric patch on the trunk or arms.

The Significance of Trans-Epidermal Water Loss After Microneedling and Microneedling-Radiofrequency Procedures: Histological and IRB-Approved Safety Study.

Background: Microneedling (MN) and microneedling-radiofrequency (MN-RF) result in skin rejuvenation and skin exposure to pathogens.

Objectives: The aim was to determine histopathological changes of needle-depth injuries in preauricular skin and measure time-dependent repair of transepidermal water loss (TEWL) in subjects.

Methods: MN and MN-RF procedures were performed at 0.

A Preliminary Clinical Trial Comparing Split Treatments to the Face and Hand With Autologous Fat Grafting and Platelet-Rich Plasma (PRP): A 3D, IRB-Approved Study.

Background: Numerous methodologies have been suggested to enhance fat graft survival, but few long-term studies are available.

Objectives: The authors of this institutional review board-approved study investigated the safety and efficacy of utilizing platelet-rich plasma (PRP).

Methods: Each of 10 patients received equal volumes of syringe-harvested, centrifuged fat to opposing midfaces with a lateral submuscular aponeurotic system-plication or no face lift and hands that were combined with equal volumes of either concentrated PRP or normal saline.

Review of Human Hair Follicle Biology: Dynamics of Niches and Stem Cell Regulation for Possible Therapeutic Hair Stimulation for Plastic Surgeons.

Plastic surgeons are frequently asked to manage male- and female-pattern hair loss in their practice. This article discusses the epidemiology, pathophysiology, and current management of androgenetic alopecia and emphasizes more recent knowledge of stem cell niches in hair follicles that drive hair cycling, alopecia, and its treatment. The many treatment programs available for hair loss include newer strategies that involve the usage of growth factors, platelet-rich plasma, and fat to stimulate follicle growth.

A new wrinkle: Umbilical cord management (how, when, who).

In the past five years, umbilical cord management in both term and preterm infants has come full circle, going from the vast majority of infants receiving immediate cord clamping to virtually all governing organizations promoting placental transfusion, mainly in the form of delayed cord clamping (DCC). Placental transfusion refers to the transfer of more blood components to the infant during the first few minutes after birth. The different strategies for ensuring placental transfusion to the baby include delayed (deferred) cord clamping, milking of the attached cord before clamping, and milking of the cut cord.

A Split Face Study to Determine the Significance of Adding Increased Energy and Treatment Levels at the Marionette Folds.

Background: Microfocused ultrasound with visualization (MFU-V) has become a safe and effective means to tighten skin and subdermal structures by optimizing the amount of joule energy and treatment tissue planes for improved customization for the individual patient. To date, there have been an absence of split treatments to verify algorithms.

Objectives: The aims of this institutional review board-approved investigation and clinical experience were to clarify the safety and efficacy of current treatment guidelines.

Micro-Needling Depth Penetration, Presence of Pigment Particles, and Fluorescein-Stained Platelets: Clinical Usage for Aesthetic Concerns.

Background: Aesthetic micro-needling (MN) has demonstrated skin permeability to cosmeceutical ingredients and platelet-rich plasma by creating reversible micro-channels in the skin.

Objectives: The purposes of this study were to determine: (1) actual needle depth-penetrations by adjusting needle lengths in a disposable tip of an electric MN device; (2) time-dependent passage of pigment and platelets; and (3) safety and efficacy profiles in patients.

Methods: Excised micro-needled pre-auricular skin was used to determine actual depths of tissue penetration with six needle lengths, and the presence of massaged pigment particles (histological examination) and fluorescein-labeled platelets (confocal laser microscopy) in 1 mm depth micro-channels over an hour.

Umbilical Cord Milking Versus Delayed Cord Clamping in Preterm Infants.

Background And Objective: Delayed cord clamping (DCC) is recommended for premature infants to improve blood volume. Most preterm infants are born by cesarean delivery (CD), and placental transfusion may be less effective than in vaginal delivery (VD). We sought to determine whether infants <32 weeks born by CD who undergo umbilical cord milking (UCM) have higher measures of systemic blood flow than infants who undergo DCC.

Early clinical experience with the 1440-nm wavelength internal pulsed laser in facial rejuvenation: two-year follow-up.

This article reports on the early experience with the 1440-nm wavelength, using a specially designed side-firing fiber, in a four-step approach, primarily to the lower third of the midface and neck. The author presents the clinical protocol, procedure steps, outcomes, and adverse events of use of the laser. Outcomes are described at 3 months, 6 months, and 18 months.

Esophageal coin removal by emergency physicians: a continuous quality improvement project incorporating rapid sequence intubation.

Objective: The objective of this study was to describe our experience removing esophageal coins from children in a tertiary care pediatric emergency department over a 4-year period.

Methods: We retrospectively reviewed a continuous quality improvement data set spanning October 1, 2004, through September 30, 2008.

Results: In 96 of 101 cases (95%), emergency physicians successfully retrieved the coin.