Medicine
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Reconstruction of breast defects of patients who underwent mastectomy can be challenging. This study was designed to review a series of 43 breast cancer patients who underwent immediate breast reconstruction (IBR) using the latissimus dorsi myocutaneous flap with/without implants. The demographic characteristics, clinical application feasibility, and the satisfaction rates of the patients were retrospectively collected and evaluated. ⋯ In the present study, the reconstructed breast has natural shape, good symmetry, and hidden postoperative scars. The aesthetic effect is relatively good, and the use of LDMF may represent an acceptable and valid option for IBR. The success of this procedure depends on the design of the incision, the skill and proficiency of the operation, as well as the correct treatment after surgery.
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Comparative Study
Comparison of endoscopically determined gross tumor volume and metabolic tumor volume in esophageal cancer.
The purpose of this study is to compare the longitudinal location of endoscopically-defined gross tumor volume (GTV) and positron emission tomography-based metabolic tumor volume (MTV) of esophageal cancer. A retrospective review of medical records was performed of the nine patients who underwent endoscopic placement of fiducial markers for radiotherapy of esophageal squamous cell carcinoma. Endoscopic hemoclips were used as the fiducial markers, and GTV was newly delineated solely based on the locations of the fiducial markers. ⋯ The fixed absolute threshold method was suitable for determining the MTV threshold for esophageal lesions. A SUV of 2.5 was appropriate for esophageal tumors with a maximum SUV > 20. Endoscopic hemoclips were stable enough for using as the fiducial marker.
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Observational Study
Ropivacaine continuous wound infusion after mastectomy with immediate autologous breast reconstruction: A retrospective observational study.
Continuous wound infusion usually provides postoperative analgesia as a multimodal analgesia with systemic opioid use. When continuous wound infusion of local anesthetics (LA) supports successful postoperative analgesia without systemic opioid use, the side effects of opioid can be reduced. Nevertheless, continuous wound infusion after mastectomy with immediate autologous breast reconstruction leads to concerns about wound healing. ⋯ The satisfaction score of analgesia in the ON-Q group was comparable with that of the patients in the IV PCA group. This study demonstrates that single use of continuous wound infusion showed comparable analgesia with fentanyl-based IV PCA in patients who underwent mastectomy with immediate autologous breast reconstruction. Furthermore, the continuous infusion of LA directly on the surgical site did not significantly affect wound healing.
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Asthma is the most frequently occurring obstructive airway disease, it inflicts the highest morbidity among children. Among the paediatric populace, severe exacerbations of asthma are a common reason behind patient consultations and hospitalizations. Oral corticosteroids are a primary component in the treatment of asthma exacerbations; however, there is controversy regarding how corticosteroids functions. ⋯ May 20, 2021.osf.io/3ghjt. (https://osf.io/3ghjt/).
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The aim of this study was to compare outcomes for single-event multilevel surgery (SEMLS) in cerebral palsy (CP) performed by 1 or 2 attending surgeons. A retrospective review of patients with CP undergoing SEMLS was performed. Patients undergoing SEMLS performed by a single senior surgeon were compared with patients undergoing SEMLS by the same senior surgeon and a consistent second attending surgeon. ⋯ Employing 2 attending surgeons in SEMLS decreased operative time and OR utilization cost, particularly in patients with a high surgical burden. These findings support the practice of utilizing 2 attending surgeons for SEMLS in patients with CP. Level of Evidence: Level III.