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pared with group 1, the two reviewers encountered significantly greater satisfaction with surgical outcomes among patients of group 2 (p < 0.01).

In FACE-Q scoring, those undergoing lift-and-fill procedures reported the highest satisfaction levels.

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Reduction mammoplasty in patients with gigantic breast hypertrophy runs a high risk of complication. Traditionally, inferior pedicle reductions or free nipple grafting techniques have been recommended for gigantic breasts on the basis of measurements and expected resection weights. The superiomedial pedicle (SMP) technique has been less commonly used, due to concerns of vascular inadequacy. This study examines the outcomes of SMP in large reductions and outlines suggested modifications for enhanced safety.

This is a retrospective review of all patients who underwent SMP breast reduction in our institution between 2005 and 2016. Included are cases with resection weights greater than 800g.

A total of 173 patients with 341 breasts were included. Mean sternal notch to nipple (SNN) distance was mean 35.0 ± 6.6cm (range 23-44.5) on the left and 34.9 ± 6.6cm (range 18-46) on the right. Mean resection weight was 1152.2 ± 368.6g (range 810-2926) on the left and 1159.4 ± 326.6g (range 800-2528) on the right. The e of Contents or the online Instructions to Authors www.springer.com/00266.Social media sites and platforms have grown in numbers with an enormous potential to reach and disseminate information in real time. They are impacting tremendously for better or for worse on the current practice of plastic surgery. As the demand for elective plastic surgery, in particular for aesthetic procedures, continues to rise, there is a need to determine the influence of social media advertisements and how it motivates the public to undergo cosmetic procedures. Most importantly, there is an urgent need to determine how the social media are impacting plastic surgery practice building and what is proper and efficient marketing while upholding ethics of the medical profession? A thorough PICO tool-based comprehensive literature search was conducted. Fifty-one peer-reviewed publications, 15 patient-centered, 33 provider-centered, and three combined patient/provider were identified to be relevant to the use of social media in plastic surgery and were selected for this review. Evidence on how social media influences the medical practice and helps in practice building remains scarce; nevertheless, reliance of plastic surgeons on social media to improve their practice has been increasing steadily. Social media may be a powerful tool to promote one's career. It presents, however, serious professional, legal, and ethical challenges including maintenance of professionalism and protecting patient confidentiality. If misused, it may be a quick way to end a plastic surgery practice.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The complexity of the symptoms of fibromyalgia syndrome (FMS) poses aparticular challenge for both those affected and those treating persons with the condition. The present study deals with the questions of coping with FMS from the perspective of both those affected and those treating them and their assessment of needs and requirements in terms of health services.

In aqualitative study design, the individual views of 10FMS patients and 10healthcare providers were examined. The patients were selected by means of "purposive sampling" and questioned in guideline-based, problem-centred interviews. Evaluation was carried out by means of content analysis.

Both FMS patients and healthcare providers noted problems with availability and accessibility of health services. In addition, some patients felt that they were not taken seriously by their healthcare providers. Care providers in turn experienced reservations about the psychosomatic component on the part of patients. Self-initiative seems to be important for apositive approach to living with FMS.

Self-help groups and regionally available networks represent important support possibilities, not least with regard to the psychosomatic component of FMS. Improved coordination of care services can be achieved by promoting interdisciplinary networking. Strengthening the self-initiative of patients and promoting the work of self-help groups can help those affected to develop individual coping strategies.

Self-help groups and regionally available networks represent important support possibilities, not least with regard to the psychosomatic component of FMS. Improved coordination of care services can be achieved by promoting interdisciplinary networking. Strengthening the self-initiative of patients and promoting the work of self-help groups can help those affected to develop individual coping strategies.Antineutrophil cytoplasmic autoantibodies (ANCA) associated vasculitis (AAV) consists of a group of systemic autoimmune diseases. The roles of serum anti-nuclear antibodies (ANA) and anti-double-stranded DNA (anti-dsDNA) antibodies in AAV patients remain unknown. This study investigated the prevalence of serum ANAs and anti-dsDNA antibodies in AAV patients and characterized the clinical and pathological features of these patients. A total of 218 AAV patients were enrolled. selleck chemicals llc Clinical and pathological data of patients were analyzed retrospectively. Of the 218 AAV patients, 109 (50.0%) were positive for ANA, 45 (20.6%) were positive for anti-dsDNA, and 43 (19.7%) were positive for both. The AAV patients with ANA had severer kidney damage and more chronic renal histopathological changes compared to those who were negative for ANA. Specifically, patients positive for ANA had more hypertension, higher levels of urea nitrogen and serum creatinine, lower estimated glomerular filtration rate (eGFR), more end-stage renal disease (ESRD), severer proteinuria, glomerular sclerosis, tubular interstitial fibrosis and tubular atrophy, and were more likely to receive renal biopsies compared to ANA negative patients.