Medicine
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Review Case Reports
Survival of umbilicus on a superiorly based flap after fleur-de-lis abdominoplasty: A case report.
Massive weight loss patients have a midline excess of abdominal adipose and skin tissue that contributes to an increased abdominal girth. This excess of tissue in these patients is not resolved with traditional techniques of abdominoplasty and usually the fleur-de-lis abdominoplasty technique is employed. ⋯ In this case report we review our experience treating a massive weight loss patient using a fleur-de-lis abdominoplasty technique without preserving the umbilicus blood supply via the inferior epigastric artery and median umbilical ligament. We eventually relied on the collateral blood supply from ligamentum teres and superior epigastric collaterals, something that proved advantageous both in the survival of the umbilicus on the long run despite cutting off the main blood supply, and, the removal of further excess adipocutaneous tissue for a better aesthetic outcome.
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Supracondylar humerus fractures (SHF) are the second most common fracture in children and the most common fracture in children under seven years. Subtle neurovascular lesions in displaced SHF may be underdiagnosed clinically, but their sequelae can mean life-long symptoms. Here we show that color-coded duplex ultrasound (DUS) could help to identify these patients. ⋯ DUS can be a sensitive tool in diagnosing vascular impairments in patients with SHF. It could reduce diagnostic insecurity, especially in anesthetized or otherwise hard to examine children, and thus help avoid the therapeutic delay that otherwise might foster life-long sequelae for the patients. More studies are needed to establish age-adjusted reference values for duplex-sonography of children's arms. Level of Evidence: Level III, Study of nonconsecutive patients (without consistently applied reference).
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Omicron, the new Covid-19 variant, has already become dominant in many countries and is spreading at an unprecedented speed. The objective of this study was to review the existing literature on Omicron's transmissibility, immune evasion, reinfection, and severity. A literature search was performed using "PubMed," "Web of Science," "Scopus," "ScienceDirect," "Google Scholar," "medRxiv," and "bioRxiv." Data were extracted from articles that reported at least one of the following: transmissibility, immune evasion, reinfection, and severity related to Omicron. ⋯ Despite Omicron's higher potential to evade immunity, vaccines and booster shots were found to be still significantly effective in protecting against severe Covid-19 infections. Omicrons may be less severe than other variants of concern. However, its immune evasiveness and rapid spread pose an enormous threat to the global healthcare system.
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Functional dyspepsia and digestive disorders are common, debilitating and costly. Little information is available about the role of stress management in terms of cognitive-behavioral treatment of dyspepsia. We performed a protocol for systematic review and meta-analysis to evaluate the effectiveness of cognitive behavior stress management for the treatment of functional dyspepsia. ⋯ The result of this review will provide more reliable references to help clinicians make decisions when dealing with functional dyspepsia.
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Primary surgical treatment for oral squamous cell carcinoma (OSCC) is reserved for T1 to T4a tumors, but not for T4b tumors, according to the present National Comprehensive Cancer Network clinical practice guidelines. In this retrospective study, we aimed to determine the association between the clinicopathological characteristics and different treatment modalities for T4b OSCC based on whether patients received primary surgical treatment. Therefore, we conducted a survival analysis based on different treatment modalities. ⋯ In the present study, patients with T4b OSCC treated with primary surgery had a better overall survival rate than those who received nonsurgical treatment. In the future, it will be necessary for clinicians worldwide to report the treatment outcomes of patients with T4b OSCC based on the common criteria.