Edvardsenmontoya0277
Deep inferior epigastric artery perforator (DIEP) flap surgery is one of the most common techniques for breast reconstruction using abdominal tissue. Although the DIEP flap reduces donor-site morbidity when compared with the conventional free transverse rectus abdominis musculocutaneous flap, violation of the anterior rectus sheath, rectus muscle, and motor nerves cannot be avoided. To further minimize tissue damage in the donor site, the use of a surgical robotic system for DIEP flap harvest with a totally extraperitoneal approach has been suggested. This totally extraperitoneal approach has a long learning curve because of the narrow preperitoneal space and the difficulty of converting a potential space to an actual space. Thus, the authors suggest a single-port robotic system optimized for narrow surgical spaces as a feasible option for DIEP flap harvest by a totally extraperitoneal approach, which has a shorter learning curve.
Deep inferior epigastric artery perforator (DIEP) flap surgery is one of the most common techniques for breast reconstruction using abdominal tissue. Although the DIEP flap reduces donor-site morbidity when compared with the conventional free transverse rectus abdominis musculocutaneous flap, violation of the anterior rectus sheath, rectus muscle, and motor nerves cannot be avoided. To further minimize tissue damage in the donor site, the use of a surgical robotic system for DIEP flap harvest with a totally extraperitoneal approach has been suggested. This totally extraperitoneal approach has a long learning curve because of the narrow preperitoneal space and the difficulty of converting a potential space to an actual space. Thus, the authors suggest a single-port robotic system optimized for narrow surgical spaces as a feasible option for DIEP flap harvest by a totally extraperitoneal approach, which has a shorter learning curve.
Women with cosmetic breast implants have significantly lower rates of subsequent breast cancer than the general population (relative risk, 0.63; 95 percent CI, 0.56 to 0.71). The authors hypothesize that breast implant-induced local inflammation stimulates immunosurveillance recognition of breast tumor antigen.
Sera were collected from two cohorts of healthy women women with long-term breast implants (i.e., breast implants for >6 months) and breast implant-naive women. Antibody responses to breast tumor antigens were tested by enzyme-linked immunosorbent assay and compared between cohorts by unpaired t test. Of the implant-naive cohort, nine women underwent breast augmentation, and antibody responses before and after implant placement were compared by paired t test.
Sera were collected from 104 women 36 (34.6 percent) long-term breast implants and 68 (65.4 percent) implant-naive women. Women with long-term breast implants had higher antibody responses than implant-naive women to mammaglobin-A (optical density at 450 nm, 0.33 versus 0.22; p = 0.003) and mucin-1 (optical density at 450 nm, 0.42 versus 0.34; p = 0.02). There was no difference in antibody responses to breast cancer susceptibility gene 2, carcinoembryonic antigen, human epidermal growth factor receptor-2, or tetanus. Nine women with longitudinal samples preoperatively and 1 month postoperatively demonstrated significantly elevated antibody responses following implant placement to mammaglobin-A (mean difference, 0.13; p = 0.0002) and mucin-1 (mean difference 0.08; p = 0.02). There was no difference in postimplant responses to other breast tumor antigens, or tetanus.
Women with long-term breast implants have higher antibody recognition of mammaglobin-A and mucin-1. This study provides the first evidence of implant-related immune responses to breast cancer antigens.
Therapeutic, V.
Therapeutic, V.
Restoring the sensation of the reconstructed breast has increasingly become a goal of autologous breast reconstruction. The aim of this study was to analyze the sensory recovery of the breast and donor site of innervated compared to noninnervated deep inferior epigastric perforator (DIEP) flap breast reconstructions, to assess associated factors, and to compare the differences between preoperative and postoperative sensation.
A prospective cohort study was conducted, including patients who underwent innervated or noninnervated DIEP flap breast reconstruction between August of 2016 and August of 2018. Nerve coaptation was performed to the anterior cutaneous branch of the third intercostal nerve. Preoperative and postoperative sensory testing of the breast and donor site was performed with Semmes-Weinstein monofilaments.
A total of 67 patients with 94 innervated DIEP flaps and 58 patients with 80 noninnervated DIEP flaps were included. Nerve coaptation was significantly associated with lower mean monofilament values for the breast (-0.48; p < 0.001), whereas no significant differences were found for the donor site (-0.16; p = 0.161) of innervated compared to noninnervated DIEP flaps. Factors positively or negatively associated with sensory recovery of the breast and donor site were identified. Preoperative versus postoperative comparison demonstrated significantly superior sensory recovery of the breast in innervated flaps (adjusted difference, -0.48; p = 0.017).
This study demonstrated that nerve coaptation in DIEP flap breast reconstruction significantly improved the sensory recovery of the breast compared to noninnervated flaps. The sensory recovery of the donor site was not compromised in innervated reconstructions. The results support the role of nerve coaptation in autologous breast reconstruction.
Therapeutic, II.
Therapeutic, II.
Brown, AF, Alfiero, CJ, Brooks, SJ, Kviatkovsky, SA, Smith-Ryan, AE, and Ormsbee, MJ. Prevalence of normal weight obesity and health risk factors for the female collegiate dancer. J Strength Cond Res 35(8) 2321-2326, 2021-The purpose of this study was to investigate the prevalence of normal weight obesity (NWO) and evaluate the relationship between NWO and health risk factors in a collegiate dancer population. Reanalysis of data of female dancers (N = 42) from 2 larger studies was used to assess prevalence and health risk factors of NWO. Dancers completed a dual-energy x-ray absorptiometry scan to assess fat mass (FM), lean mass (LM), and visceral adipose tissue (VAT) and a 3-day food record. Normal weight obesity was defined as a body mass index (BMI) of 18.5-24.9 kg·m-2 and body fat (BF) ≥30%. Twenty-five (60%) dancers were classified as normal weight lean (NWL), and 17 dancers (40%) were classified as NWO. Significant differences were observed for BMI (NWL 21.1 ± 1.7, NWO 23.1 ± 1.6, p < 0.001), LM (Nfference was observed for carbohydrate intake (NWL 4.7 ± 1.8 g·kg-1, NWO 3.7 ± 1.0 g·kg-1, p = 0.020) between groups. Significant positive correlations with FM were observed between carbohydrate (kcal, p = 0.048), fat (kcal, p = 0.018; g·kg-1, p = 0.040), and total calories (p = 0.019) in NWO. Normal weight obesity in collegiate dancers may be more prevalent than previously perceived and may be significantly related to important health risk factors. The current study demonstrates the need for body composition assessments and emphasizing on promoting overall health in collegiate dancers.
Nowak, R, Kostrzerwa-Nowak, D, and Buryta, R. Analysis of selected lymphocyte (CD45+) subset distribution in capillary blood of young soccer players. J Strength Cond Res 35(8) 2279-2286, 2021-Mechanisms responsible for increasing athletes' physical capacity and induction of exercise-induced immunosuppression processes are not fully understood. The aim of the study was to monitor changes in percentages of lymphocyte subsets T, Th, Tc, B, and NK cells in capillary blood of junior soccer players. Ten subjects median aged 18 years (range 17-19 years) were recruited form young soccer players. Capillary blood was collected 24 hours after each soccer match during the 8 weeks of the final phase of Central Junior League competition, and white blood cell (WBC) phenotyping was performed to determine the percentages of B lymphocytes, NK cells, and T-lymphocyte subsets. Cumulative match-time (a sum of time spend playing the game by each athlete during the observation period) was also calculated. Significant changes in t0.0035, for lymphocytes and Th cells, respectively). It seems that the exercise bouts are among considerable factors influencing the changes in WBC subsets, especially in CD3+ cells, among young soccer players. Regarding the number of games played and training loads, they are more susceptible to immunosuppression and subsequent infections and thus should be monitored regarding WBC phenotype assessment.
Uthoff, A, Oliver, J, Cronin, J, Winwood, P, Harrison, C, and Lee, JE. Resisted sprint training in youth the effectiveness of backward vs. forward sled towing on speed, jumping, and leg compliance measures in high-school athletes. J Strength Cond Res 35(8) 2205-2212, 2021-Resisted sprinting (RS) is a popular training method used to enhance sprinting performance in youth. However, research has only explored the effects of forward RS (FRS) training. We examined the effects of FRS and backward RS (BRS) and compared these with a traditional physical education curriculum (CON). One hundred fifteen boys (age 13-15 years) were matched for maturity and allocated to either an FRS (n = 34), BRS (n = 46), or CON (n = 35) group. Training groups towed progressively overloaded sleds (20-55% body mass) 2 d·wk-1 for 8 weeks. Pre-training and post-training data were collected for sprinting times over 10 and 20 m, countermovement jump (CMJ) height, and leg stiffness (KN). Performance remained unchanged for the CON group (allBRS (∼70%) were on average ∼10 and ∼8% better than the FRS and CON groups, respectively. The BRS and FRS showed similar probabilities of improving CMJ (75 and 79%) and KN (80 and 81%), respectively, over the CON group. It seems that BRS may be a means to improve sprint performance, and regardless of direction, RS seems to be a beneficial method for improving jumping height and leg stiffness in youth male athletes.
Rider, BC, Conger, SA, Ditzenberger, GL, Besteman, SS, Bouret, CM, and Coughlin, AM. Examining the accuracy of the Polar A360 monitor. J Strength Cond Res 35(8) 2165-2169, 2021-The purpose of this study was to determine the accuracy of the Polar A360 heart rate (HR) monitor during periods of rest, walking/running, and active/passive recovery from exercise. Thirty collegiate athletes (women n = 15 and men n = 15) wore an A360 monitor and a previously validated chest HR monitor (Polar RS400) that served as the criterion measurement across a range of resting and walking/running intensities. First, subjects rested in a supine, seated, and standing position. Next, each subject walked on a treadmill at 1.6 kilometers per hour (kph). Speed was increased by 1.6 kph every 2 minutes until volitional fatigue. Then, subjects walked at 4.8 kph followed by a seated recovery stage. Heart rate was recorded in 30-second increments. Total mean difference in HR readings, percent accuracy, and intraclass correlation coefficieno examine the agreement between devices. The A360 demonstrated a strong correlation with the RS400 (r2 = 0.98) across time points. The analysis of variance with repeated measures indicated an overall significant difference (p less then 0.001) between devices. find more The A360 significantly underestimated HR during the 6.4-kph speed only (p less then 0.05) (effect size 0.26). The greatest percent accuracy occurred during rest (91%) and recovery (90%). An ICC of 0.98 (SEM 0.35) demonstrates a strong level of agreement between devices. The A360 is accurate at rest and during various walking and running speeds and thus is a device that can be used with confidence by athletes for specific training purposes. Future research should examine accuracy during weight training and other sport-specific activities.
