1,720,966 research outputs found
Variabili predittive di insoddisfazione postoperatoria a seguito di interventi di chirurgia estetica
No full textil metro fondamentale con cui misurare l’outcome degli interventi
di chirurgia estetica. Essa tende a essere condizionata
da variabili socio-demografiche, anamnestiche e soprattutto
psicopatologiche su cui, al momento, non esiste un consenso.
Obiettivo dello studio è determinare il grado in cui le suddette
variabili possano ritenersi predittive di insoddisfazione. Le
variabili cliniche valutate sono: tratti patologici di personalità,
narcisismo covert, entità del disagio relativo all’immagine
corporea.
Metodi: il campione è risultato composto da 77 soggetti
(91,3% F) tra i 18 e i 57 anni di età sottoposti a diversi tipi di
interventi di chirurgia estetica presso due ospedali milanesi,
tra il 2009-2010. È stata impiegata una batteria di questionari
finalizzata alla rilevazione delle variabili di interesse.
Risultati: tra le variabili considerate, i migliori predittori
dell’insoddisfazione post-operatoria risultano: precedenti procedure
estetiche chirurgiche, la gravità e la precocità dell’insorgenza
del disagio relativo all’immagine del corpo, il numero
dei tratti patologici della personalità in generale e quelli
riconducibili ai disturbi del cluster B in particolare. Esse risultano
inoltre correlate a motivazioni estrinseche e aspettative
irrealistiche rispetto all’esito dell’intervento.
Conclusioni: i dati supportano l’utilità di una valutazione clinica
da parte dei professionisti della salute mentale per tutti i
candidati a un intervento di chirurgia estetica
"Variabili predittive di Objectifying Objectifying post-operatoria a seguito di interventi di chirurgia estetica".
No full textSuspected breast implant rupture: our experience, recommendations on its management and a proposal for a model of informed consent
Get PDFStevens-Johnson syndrome and toxic epidermal necrolysis: 11-year retrospective experience in a high-complexity tertiary hospital in Milan, Italy
No full textStevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe drug-induced hypersensitivity reactions characterized by widespread epidermal necrosis, mucous membrane erosions, and systemic findings. We have provided our 11-year experience from a Milan, Italy tertiary hospital managing SJS/TEN, evaluating the clinical and histopathologic features plus the impact on mortality. We retrospectively analyzed 28 patients diagnosed with SJS/TEN based on the clinical and histopathologic findings, according to the classification criteria of multiple studies. We assessed the dermatographics, comorbidities, drug history, lesion characteristics, clinical findings, treatments, blood tests, and outcomes. Severity scores (SCORTEN, Re-SCORTEN, ABCD-10) were used for treatment evaluation and mortality prediction. Data were statistically analyzed, and significant factors associated with mortality were identified. We found that among the 28 patients, 89.2% had comorbidities, mainly cardiovascular diseases, and 21.4% had autoimmune disorders. All patients had received systemic therapy (46.6% monotherapy, 53.6% combination therapy), with systemic steroids (71.4%) and intravenous immunoglobulins (67.8%) being common treatments. There were complications, including systemic infections (67.9%) and septic shock (10.7%). The overall mortality rate was 17.8%. The statistical analysis indicated that malignancy, a high ABCD-10 score, and a high neutrophil-to-lymphocyte ratio were significantly associated with mortality. The extent of affected body surface area did not correlate significantly with mortality. This study provides insights into SJS/TEN management, revealing factors influencing mortality in a high-complexity tertiary hospital setting
Body image and personality disorders in cosmetic surgery settings
No full textObjectives: Psychiatric disorders characterized by body image disorder (BID) such as body dysmorphic disorder, are relatively common in cosmetic surgery settings and several authors suggested the need for a preoperative clinical evaluation of Axis I and Axis II comorbidity. Study 1 investigated the prevalence of Personality Disorders (PDs) and Study 2 investigated the comorbidity between BID and PDs in patients seeking cosmetic surgery. Methods: Sixty two patients (study 1) scheduled for aesthetic rhinoplasty (62,9% F; Mage = 34.47 ± 10.69 ys) and 80 patients (study 2) scheduled for profile, breast and body contouring cosmetic surgery from two Italian hospitals (91% F; Mage = 32.68 ± 3.63) completed the Body Uneasiness Test (BUT) and the Personality Diagnostic Questionnaire - 4+ (PDQ-4+) with the exception of the items relating to two appendix PDs. Results: 19.6% and 17.5% of subjects (study 1 and 2, respectively), had at least 1 PD. In both studies, cluster B and C PDs are the most prevalent. In particular, the five most prevalent PDs were: obsessive-compulsive, avoidant, narcissistic, borderline and histrionic PD. In study 2, using the BUT cut-off score as a marker of clinical significance, 43.8% of subjects had a BID and all PD patients showed comorbidity with BID. Conclusion: Our study supports the evidence that PDs and BIDs are common in cosmetic surgery settings, as well as the importance of preoperative clinical evaluation of these disorders
Do cosmetic surgery patients need a preoperative psychiatric evaluation.
No full textSeveral studies show that the dissatisfaction with body image is the main factor motivating people to undergo cosmetic surgery. However it’s essential to differentiate between “normal discontent” and the excessive concern that causes clinical significant distress to the individual. Literature suggests that patients with Body Image Disorder (BID) and Personality Disorders (PD) remain constantly dissatisfied and asked for additional operations for the same or other body areas. This study intends to investigate the role of BID and of PD in conditioning the post-operative patient satisfaction and to determine the prevalence of these disorders and their comorbidity. In the pre-operative stage sample was composed of 80 patients (91% F, 9% M; Mage = 32.68) and in the post-operative stage (13 months after the operation) the sample was composed of 77 patients. Participants completed self-report questionnaires. The post-operative patient satisfaction is conditioned by number of pathological personality traits and the existence of clinically significant distress related to body image in the pre-operative stage (Global Severity Index); all patients with a BID in the pre-operative stage continue to show the BID after the operation. 17.5% of subjects show at least one diagnosis of PD, 43.75% one of BID, and in all patients who have a PD there‘s a coexistence of BID. The results support the importance of a clinical evaluation for every patient seeking cosmetic surgery in order to avoid aesthetic plastic surgery on patients with psychiatric disorder
Do cosmetic surgery patients need a preoperative psychiatric evaluation?
No full textSeveral studies indicate that the media are a significant factor in the development and maintenance of eating and shape-related disorders. Objectification theory (Fredrickson and Roberts 1997) represents a cohesive framework to understand how sociocultural pressures are translated into psychological risk factors potentially promoting body image and eating problems. Effects of objectifying media on body image and on eating disorder symptomatology in an Italian sample have been examined. A sample of 113 men and 119 women (Mage = 20.60) completed questionnaire measures of exposure to Italian objectifying media, body surveillance, body shame and eating disorder symptomatology. As far as for women, the exposure to objectifying media leads to body surveillance which in turn leads to body shame, that is related to the etiology of disordered eating. Path analyses indicated similar results (even if weaker) for men. Women obtained medium scores significantly higher in every variable. We found gender issues in body surveillance and shame if considered as mediator variables. The results confirm that our society’s focus on external appearance has negative mental- health consequences for both men and women. In terms of practical implications, the data support the use of media literacy as a promising prevention approach, as well as the use of cognitive-behavioral and other integrated treatments for negative body image (e.g. virtual reality) which aim to decrease the central importance of appearance and thus reduce the risk for the development of eating disorders
The impact of cosmetic surgery on body image and psychological well-being: an Italian follow up study
No full textBackground: It has been postulated that the goal of cosmetic surgery is to facilitate improvement in the patient's psychological functioning primarily by modifying the patient's body image (Pruzinsky, 1993). This study intended to investigate pre and post-operative changes in psychological well-being and body image.
Methods: Seventy seven patients (91% F; Mage = 32.68) scheduled for profile, breast and body contouring cosmetic surgery from two Italian hospitals completed the Body Uneassiness Test (BUT) and the Psychological General Well-Being Index Short Version before and 13 months after surgery.
Findings: Cosmetic surgery, irrespective of the specific type of operation, has a positive impact on psychological well-being. Instead the improvement in the distress related to body image depends on the pre-operative degree of severity (Global Severity Index of BUT): all patients with a body image disorder in the pre-operative stage (45.45%, measured using the cut-off value of BUT) continue to show this even 13 months after the operation.
Discussion: The results confirm that a positive change in physical appearance leads to an improvement in psychological well-being. Nevertheless, the improvement in the distress related to body image was found only in patients without body image disorders (BID). Additionally, consistent with literature, this study outlines the high prevalence of BID in patients who demand aesthetic procedure and suggests therefore the importance of a preoperative clinical evaluation
Do clinical variables predict poor post-operative satisfaction in patients who demand cosmetic surgery?
No full textObjectives: Although most patients are satisfied with cosmetic surgery and experience a positive psychosocial outcome, evidence suggests that some - known as “insatiable patients” or “polysurgical addicts” - are chronically dissatisfied despite technically satisfactory surgical results, leading to problems for both patients (i.e. social isolation, depressed mood, adjustment problems, familial dysfunction, self-destructive behaviors) and surgeons (harassment by patients for further surgical procedures, complaints and legal action). Body image disturbances and personality disorders were shown to be associated with patient’s dissatisfaction. However, as argued by Honigman et al. (2004), these conclusions are mostly based on clinical impressions, and no study so far has analyzed the predictors of poor satisfaction. Thus, this study is aimed at filling this gap and at assessing the impact of the following clinical variables on patient’s post-operative dissatisfaction: number of pathological personality traits; covert narcissism; severity of body uneasiness; worries about particular body parts and intensity of these concerns; psychological well-being. Methods: Seventy-seven patients (91% F), aged 18–57 (Mage = 32.68) scheduled for profile, breast and body contouring cosmetic surgery from two Italian hospitals completed four self-report questionnaires before surgery and a measure of patient satisfaction 13 months after surgery. Results: Among all the variables considered, the number of pathological personality traits (cluster B’s in particular), the severity of body uneasiness and the intensity of worries about body parts showed a predictive power on patients’ dissatisfaction. Conclusion: Our data suggest that a thorough pre-operative clinical assessment may allow the pre-operative identification of patients with low levels of post-operative satisfaction
Disturbi dell’immagine corporea e disturbi di personalità in chirurgia plastica estetica, e valutazione dell’impatto dell’intervento sul disagio legato all’immagine corporea
No full textIntroduzione: Lo studio si prefigge di indagare: a) l’impatto
degli interventi di chirurgia estetica sul disagio legato all’immagine
corporea attraverso un confronto pre-post dei punteggi
ottenuti al Body Uneasiness Test (Global Severity Index
– GSI – di BUT); b) la prevalenza dei disturbi dell’immagine
corporea (DIC) e dei disturbi di personalità (DP), nonché le
loro frequenze congiunte.
Metodi: Il campione iniziale è composto da 229 soggetti (90%
F, range d’età 18-59) sottoposti a diversi tipi di interventi di
chirurgia estetica presso due ospedali milanesi, tra il 2009 e il
2011. Prima dell’intervento i soggetti hanno compilato il BUT
e il Personality Diagnostic Questionnaire - 4+. Il BUT è stato
risomministrato 12 mesi dopo l’intervento (N=214).
Risultati: Nonostante l’intervento abbia un impatto positivo sul
disagio legato all’immagine corporea, il suo effetto dipende dal
terzile di appartenenza del soggetto nella distribuzione del GSI
pre-opeatorio. Infatti, tutti i soggetti che presentano un DIC nella
fase pre-operatoria continuano a presentarlo anche a distanza
di oltre un anno dall’intervento (41%). Il 20% dei soggetti
presenta almeno una diagnosi di DP (Mdiagnosi=1.55). I DP dei
Cluster B e C sono quelli prevalenti. In tutti i soggetti in cui è
presente un DP c’è anche la co-presenza di un DIC.
Conclusioni: I dati supportano l’utilità di una valutazione clinica
da parte dei professionisti della salute mentale per tutti i
candidati a un intervento di chirurgia estetica
- …
