Fanningellis7954

MT might be a useful rule-in test for guiding the use of more invasive diagnostic procedures.Elastofibroma dorsi is an uncommon benign fibroblastic pseudotumor that typically occurs in the subscapular region of middle-aged or older individuals. The pathogenesis is still unclear and a matter of debate. Magnetic resonance imaging can be used as a first-line investigation of the lesion and reveals a lenticular soft-tissue mass with a signal intensity similar to that of skeletal muscle interlaced with strands of fat. Biopsy is not necessary if all pathognomonic criteria are present. A conservative "wait and see" attitude is reasonable and immediate surgery is no more the standard treatment of elastofibroma dorsi. This review provides an updated overview of the diagnosis, management and pathogenesis of elastofibroma dorsi. We also discuss recent advances in our understanding of genomic alterations in elastofibroma dorsi.

To assess rates of cardiovascular and haemostatic events in the first 28 days after vaccination with the Oxford-AstraZeneca vaccine ChAdOx1-S in Denmark and Norway and to compare them with rates observed in the general populations.

Population based cohort study.

Nationwide healthcare registers in Denmark and Norway.

All people aged 18-65 years who received a first vaccination with ChAdOx1-S from 9 February 2021 to 11 March 2021. The general populations of Denmark (2016-18) and Norway (2018-19) served as comparator cohorts.

Observed 28 day rates of hospital contacts for incident arterial events, venous thromboembolism, thrombocytopenia/coagulation disorders, and bleeding among vaccinated people compared with expected rates, based on national age and sex specific background rates from the general populations of the two countries.

The vaccinated cohorts comprised 148 792 people in Denmark (median age 45 years, 80% women) and 132 472 in Norway (median age 44 years, 78% women), who received their first given country, and the limitations to the generalisability of the study findings.

To determine the effectiveness of closed incision negative pressure wound therapy (NPWT) compared with standard dressings in preventing surgical site infection (SSI) in obese women undergoing caesarean section.

Multicentre, pragmatic, randomised, controlled, parallel group, superiority trial.

Four Australian tertiary hospitals between October 2015 and November 2019.

Eligible women had a pre-pregnancy body mass index of 30 or greater and gave birth by elective or semi-urgent caesarean section.

2035 consenting women were randomised before the caesarean procedure to closed incision NPWT (n=1017) or standard dressing (n=1018). Allocation was concealed until skin closure.

The primary outcome was cumulative incidence of SSI. Secondary outcomes included depth of SSI (superficial, deep, or organ/body space), rates of wound complications (dehiscence, haematoma, seroma, bleeding, bruising), length of stay in hospital, and rates of dressing related adverse events. Women and clinicians were not masked, but thtion in absolute risk) compared with standard dressings. This difference was close to statistical significance, but it likely underestimates the effectiveness of closed incision NPWT in this population. The results of the conservative primary analysis, multivariable adjusted model, and post hoc sensitivity analysis need to be considered alongside the growing body of evidence of the benefit of closed incision NPWT and given the number of obese women undergoing caesarean section globally. The decision to use closed incision NPWT must also be weighed against the increases in skin blistering and economic considerations and should be based on shared decision making with patients.

ANZCTR identifier 12615000286549.

ANZCTR identifier 12615000286549.

To evaluate the justification of medical irradiation related to CT scans performed in children in Lome.

Descriptive cross-sectional study of CT scans performed from 1 September to 30 November 2019 in children aged 0 to 18 years. The analysis of the justification was made particularly on the formulation of the clinical indication, the consistency of the clinical indication with the requested CT and the conformity of the clinical indication with the Good Practice Guide (GPG) medical imaging examinations of the French Society of Radiology (SFR) and French Nuclear Medicine Society (SFMN).

The 175 CT scans included were dominated by cerebral CT (72.57%) followed by abdominal-pelvic CT (8%). Boys-dominated children (sex ratio=1.19) had an average age of 10.47+/-5.9. G Protein antagonist Prescribers composed of medical specialists (49.14%), general practitioner (31.43%) and paramedics (5%), requested in 21.14% of cases an imaging examination not or less irradiant before the CT. Clinical indication formulation was good in 70.86%, acceptable in 26.86%, and poor in 1.71%. This was consistent with the exam requested in 99.43% and conform with the GPG of the SFR in 48.57%. The more consistent the indications were with GPG, the more pathological the results were. Approximately 53% of the CT scans performed were not a priori justified.

Pediatric medical irradiation related to CT at Lome was in more than half of the cases a priori unjustified. Efforts must be made by practitioners to ensure that paediatric medical irradiation is judicious in Togo.

Pediatric medical irradiation related to CT at Lome was in more than half of the cases a priori unjustified. Efforts must be made by practitioners to ensure that paediatric medical irradiation is judicious in Togo.The result of an extra-levator abdominoperineal excision of the rectum (ELAPE) is a composite three-dimensional defect. This is performed for locally advanced anorectal cancer, and may involve partial excision of the vagina. The aim of reconstruction is to achieve wound healing, restore the pelvic floor and to allow micturition and sexual function. We aim to evaluate the concurrent use of profunda artery perforator (PAP) and bilateral gracilis flaps for vaginal and pelvic floor reconstruction. We performed a retrospective case note review of patients undergoing pelvo-perineal reconstruction with combined gracilis and PAP flaps between July 2018 and December 2019. Eighteen pedicled flaps were performed on six patients with anal or vulval malignancies. All underwent pre-operative radiotherapy. Four patients had extended abdominoperineal tumour resections, while two patients underwent total pelvic exenteration. The median age was 57 (range 47-74) years, inpatient stay was 22 (11-47) days and the follow-up was 10 (5-21) months. Four patients developed partial perineal wound dehiscence, of which one was re-sutured. One patient had a post-operative bleed requiring radiological embolisation of an internal iliac branch and had subsequent 1cm PAP flap loss. All other flaps survived completely. Median time to heal was 4 (1-6) months. This is the first series reporting combined bilateral gracilis and PAP flaps for pelvic reconstruction. The wound dehiscence rate and healing times were expected in the context of irradiation and radical pelvic tumour resection. This is a reliable technique for perineal and vaginal reconstruction with minimal donor site morbidity.Facial palsy can cause the impairment of eye closure and affect blink, ocular health, communication, and esthetics. Dynamic surgical procedures can restore eye closure in patients with decreased facial nerve function. There are no standardized measures of voluntary and spontaneous eye closure that are used to evaluate the outcomes of blink restoration procedures. The purpose of this systematic literature review was to identify the measures used to assess normal and abnormal eye closure and blinking in patients with facial palsy. A literature search of the PubMed database using the keyword "facial nerve/surgery" was conducted. Only English language articles that pertain to the use of facial paralysis assessment systems published in the past 20 years, which involve eyelid closure were included. There were 57 articles that used a facial paralysis classification system with an eyelid closure component House-Brackmann Facial Nerve Grading Scale (n = 43, 67%); Sunnybrook Facial Grading Scale (n = 9); palpebral fissure heights (n = 4), and the electronic clinician-graded facial function tool (n = 3) and three additional measures were reported once. Although the Terzis and Bruno Scoring System, blink ratio, and electronic, clinician-graded facial function scale(eFACE) Clinician-Graded Scoring System were valid measures of eyelid closure, there was no one comprehensive eye assessment that demonstrated all aspects of eye closure in facial palsy, which include closure amplitude, spontaneity, and quality of life. For blink assessment, eFACE is the most comprehensive tool currently available and recommended to be used with a patient-reported quality of life supplement that captures the specific domains related to facial nerve dysfunction.

Digital technology has been widely used in mandibular curved osteotomy to improve accuracy. However, the planning process still highly dependent on the experience and judgement of the surgeon. This study describes an automatic method to design the new gonion and osteotomy line based on the aesthetic standards in attractive women, and assesses its clinical outcomes.

An automatic surgical planning method for mandibular curved osteotomy was developed based on our previous research of mandibular angle aesthetics. A prospective clinical study was conducted from April 2016 to April 2018. Twenty-five female patients with prominent mandibular angle were enrolled. Pre- and postoperative skull computed tomography (CT) was performed. Three-dimensional (3D) CT data were obtained and processed by Mimics 18.0. Surgical templates were designed according to the automatic surgical planning method and 3D printed for the surgery. Preoperative measurements, surgical simulation and postoperative measurements were taken to evaluate the surgical outcomes.

There were significant differences between the preoperative and the postoperative groups' results (p < 0.01). There was no difference between the surgical simulation and the postoperative results. All postoperative measurements were consistent with aesthetic features of mandibles. Patients were satisfied with their outcomes in terms of outline, symmetry and lower facial width.

Our study developed an automatic method to position the new aesthetic gonion and osteotomy line for prominent mandibular angle patients. We proved that this method is safe, effective and reliable.

Our study developed an automatic method to position the new aesthetic gonion and osteotomy line for prominent mandibular angle patients. We proved that this method is safe, effective and reliable.Coronavirus disease 2019(COVID-19) is an ongoing global pandemic with a daily increasing number of affected individuals and a relatively high mortality rate. COVID-19 patients that develop cardiac injury are at increased risk of a worse clinical course with higher rates of mortality. Increasing amounts of evidence suggest that a system-wide inflammatory response and a cytokine storm mediated type syndrome plays a crucial role in disease progression. This systematic review investigates the possible role of hyperinflammation in inducing cardiac injury as one of the severe complications of COVID-19. A systematic literature search was performed using PubMed, Embase and Scopus databases to identify relevant clinical studies that investigated cardiovascular injury manifestations and reported inflammatory and cardiac biomarkers in COVID-19 patients. Only 29 studies met our inclusion criteria and the majority of these studies demonstrated significantly elevated inflammatory and cardiac blood markers. It was evident that underlying cardiovascular diseases may increase the risk of developing cardiac injury.