71 research outputs found
Free Flap Breast Reconstruction in Cancer Patients: Effect of BMI on Outcomes of the Deep Inferior Epigastric Perforator (DIEP) Flap
No full textThe 54th Annual Medical Student Research Forum at UT Southwestern Medical Center (Monday, January 19, 2016, 2-5 p.m., D1.700)BACKGROUND: The Deep Inferior Epigastric (DIEP) flap has achieved marked acceptance in free flap breast reconstruction, yet the effect of body mass index (BMI) on the procedural outcome can vary depending on the literature. This study aims to evaluate the effect of BMI on flap and donor-site complications in patients undergoing DIEP flap reconstruction.
METHODS: A retrospective analysis of 233 DIEP flaps in 135 patients was performed, and the patients were stratified as three groups based on BMI: Normal (BMI30). Data with regard to age, smoking history, comorbid conditions, preoperative radiation, preoperative chemotherapy, and complications post-DIEP flap reconstruction at the flap and donor-sites was analyzed and compared among groups.
RESULTS: Overweight patients had statistically higher rates of overall complications (p=0.001), umbilical wound (p=0.03), and return visits to the operating room during same hospital stay (p=0.004) compared to normal weight patients. Obese patients experienced statistically higher rates of overall complications (p=0.000023), return visits to operating room during same hospital stay (p=0.02), abdominal necrosis (p=0.0008), breast wound (p=0.019), umbilical wound (p=0.0053), and vacuum-assisted closure wound therapy (p=0.0006) compared to normal weight patients. There were no significant differences between the groups in regards to infection of the abdominal, breast, and umbilical sites, abdominal wound, abdominal seroma, breast necrosis, breast seroma, breast hematoma, umbilical necrosis, blood transfusion, pulmonary embolism, average OR time, average hospital length of stay, or loss of flap viability (p>0.05). Age distribution and preoperative radiation were not statistically different. Compared to normal-weight patients, overweight patients had significantly lower rates of smoking history and higher rates of hypertension, diabetes, and preoperative chemotherapy. Obese patients had statistically higher rates of preoperative chemotherapy compared to normal weight patients. These confounding factors between the groups are a limitation to the BMI control.
CONCLUSION: Overweight and obese patients undergoing DIEP flap breast reconstruction are predisposed to statistically higher risk for the aforementioned complications than normal weight patients. However, there was no significant difference in loss of flap viability between the groups. Therefore, DIEP flap breast reconstruction is an appropriate option.Southwestern Medical Foundatio
Exploring the Role of Nutrition Education in Reducing Obesity Among the U.S. Adult Population
No full textObesity is a major concern among the low-income groups, yet the problem lacks adequate awareness. It is observed that the prevalence of obesity in the United States is increasing in the U.S., this paper is focused on obtaining information on low-income participants’ knowledge about consumption of nutritious food and its contribution in preventing obesity. This paper focuses on identifying the steps that participants have been taking to prevent obesity. To reach the goal of this qualitative study two surveys were designed by the researcher. From the study, it was found that majority of the participants were aware that consumption of nutritious food is important for a healthy lifestyle. But it was also found that they had limited access to nutritious food. Hence, there is a need to implement programs that can provide better resources and awareness for low-income groups
Soil health as influenced by the integration of cover crops and poultry litter in north-central Mississippi
No full textSoil health-based agricultural management practices are widely promoted to improve soil structure, infiltration and reduce erosion. This study was conducted at two locations in North-Central Mississippi to evaluate the influence of different cover crop species and poultry litter on soil health that can impact crop production, climate change, and resilience. The results indicated that the cover crops showed a little effect on some soil health indicators compared to control treatment. However, in one location, rye, and a mixture of cover crops decreased bulk density and increased available water content and organic matter. The poultry litter had a positive effect on most soil physical and chemical health indicators. The cover crop species at Pontotoc decreased bulk density, increased field capacity, CEC, and total carbon. However, there was no significant effect of cover crops on most soil chemical health indicators, and soil responses may take more than five years for the changes to appear
Double-Pedicle Deep Inferior Epigastric Artery (DIEP) Flap for Unilateral Breast Reconstruction: Indications, Success, and Large Experience at UT Southwestern
No full textThe 54th Annual Medical Student Research Forum at UT Southwestern Medical Center (Monday, January 19, 2016, 2-5 p.m., D1.700)BACKGROUND: Unilateral breast reconstruction is challenging in patients with radiation defects, large post-mastectomy soft tissue deficits, and obese patients. Using a hemi-abdominal flap for unilateral breast reconstruction in patients may not be ideal due to paucity of abdominal tissue, presence of a lower abdominal midline scar, or a larger and/or ptotic contralateral native breast. The lower abdomen (hemi-abdominal flaps) can be used to create one breast, in a stacked manner or bipedicled non-split composite fashion.
METHODS: 51consecutive bipedicled abdominal composite free flaps for unilateral breast reconstruction were performed. Patient demographics, type/weights of flaps, number of anastomoses, length/type of pedicles, and flap related complications were recorded. Using a simplified unique algorithm that we created, the bi-pedicled flaps were anastomosed to split internal mammary artery/vein(IMA/V) or an intraflap anastomosis was performed and anastomosed to the IMA/V.
RESULTS: 51patients underwent composite DIEP and/or superficial inferior epigastric artery(SIEA) flaps (102 total flaps). Average flap weight was 1,074 +/- 466 grams (average age 57 yrs and average Body Mass Index(BMI) 26.6 +/- 3.9). 25 patients (49%) had flaps >1,000 grams (average 1,430 grams, range 1052-2400 gms), and 36 (71%) patients had flaps >750 grams. 39 patients had delayed reconstruction and 12 were immediate. 23 patients had intra-flap anastomosis over the abdomen and carried as single composite flap to cranial IMA/V; 28 patients had independent bi-pedicle flaps anastomosed to cranial and caudal split IMA/V. There were 39 DIEP-DIEP flaps,10 DIEP-SIEA flaps, and 2 SIEA-SIEA flaps. Flaps were not split in midline, but carried as a composite hemiabdominal flap with anastomosis to the IMA/V. There were no flap losses. Donor site morbidity was equivalent to bilateral breast reconstruction with DIEP flaps.
CONCLUSION: Composite bi-pedicle hemi-abdominal flaps for unilateral breast reconstruction are feasible with low complication rates but are technically challenging, chiefly in flaps >1,000 grams. To maximize aesthetic outcomes, use of highly complex double pedicle abdominal flaps is crucial in some patients, primarily those with delayed reconstruction and large contralateral breast, radiationdeficits, and large post-mastectomy defects. Technical considerations such as flap inset and handling, use of simplified algorithm, and selection of anastomosis and pedicles will be presented to make these flaps successful. This series represents an ongoing largest experience of composite bi-pedicle DIEP and/or SIEA combination for unilateral breast reconstruction.Southwestern Medical Foundatio
Electroless plating of Ni-P/PTFE composites for anti-sticking applications
No full textLAUREA MAGISTRALELa deposizione electroless è una tecnica di deposizione per metalli che non richiede elettricità e che consente l'applicazione di rivestimenti uniformi e conformi su substrati conduttivi e non conduttivi. In particolare, il la deposizione electroless di nichel ha trovato ampie applicazioni in molti settori industriali. La ricerca di proprietà migliorate ha portato a molte nuove varianti di rivestimenti in nickel electroless quali Ni-P, Ni-P/SiC, Ni-P/PTFE, Ni-P/TiO2, Ni-Cu-P, Ni-P-W. La presente review discute i rivestimenti compositi di Ni-P elettrolitici che incorporano particelle di PTFE. Il Ni-P/PTFE come materiale composito è utilizzato per via delle sue proprietà antigrippanti, del basso coefficiente di attrito, della sua uniformità, dell’elevata aderenza e delle buone proprietà di resistenza alla corrosione. Questa review studia l'effetto dell'aggiunta di PTFE in un bagno electroless, l'incorporazione di PTFE e i tipi di tensioattivi utilizzati per la corretta dispersione del PTFE. Nella parte finale, viene effettuata una sperimentazione preliminare sulla codeposizione di Ni-P con PTFE. I rivestimenti compositi ottenuti sono caratterizzati dal punto di vista morfologico e funzionale.Electroless plating is a metal deposition technique that does not require electricity and that allows the application uniform and conformal coatings on both conductive and non-conductive substrates. In particular, electroless nickel deposition has found wide applications in many industrial fields. The pursuit of improved properties has led to many newer variants of electroless nickel coatings like Ni-P, Ni-P/SiC, Ni-P/PTFE, Ni-P/TiO2, Ni-Cu-P, Ni-P-W. This review discusses the electroless Ni-P composite coatings incorporating PTFE particles. Ni-P/PTFE as a composite material is used because of its non-galling behavior, low coefficient of friction, uniformity, high adherence, and good corrosion resistance properties. This review studies the effect of PTFE addition in an electroless bath, the incorporation of PTFE, and the types of surfactants used for proper dispersion of PTFE. In the final part, some preliminary experimentation on Ni-P co-deposition with PTFE is carried out. Obtained composite coatings are characterized by the morphological and functional point of view
Visual acuity correlates with multimodal imaging-based categories of central serous chorioretinopathy
No full textObjective To evaluate visual acuity (VA) and factors influencing VA using new multimodal imaging-based classification of central serous chorioretinopathy (CSCR). Methods Retrospective, observational and cross-sectional study on 229 naive eyes diagnosed as CSCR with available baseline data and multimodal imaging. Each case was classified into (i) simple/complex/atypical; (ii) primary/recurrent/resolved; (iii) persistent or not; (iv) outer retinal atrophy(ORA) present/absent; (v) foveal involvement present/absent; and (vi) macular neovascularization(MNV) present/absent. Best corrected visual acuity (BCVA) was correlated to the classification as well as every parameter of the classification. Results Median BCVA was 0.18 logMAR [95% Confidence Interval (CI)0.16-0.18] with median duration of complaints of one month (95% CI,6.14-13.0 months). Age of the patient (r = -0.24, p = 0.002) and duration of the disease (r = -0.32, p < 0.001) correlated significantly with BCVA. Logistic regression model showed that older age [odds ratio (OR) = 0.96, p = 0.05], female gender (OR = 2.45, p = 0.046), presence of ORA(OR = 0.34, p = 0.012),and foveal involvement(OR = 0.18, p = 0.007) were statistically significantly associated with poorer BCVA. Eyes classified as complex, persistent CSCR, with ORA or foveal involvement demonstrated lower BCVA compared to those with simple, non-persistent CSCR, without ORA or without foveal involvement (p < 0.05). Eyes with complex CSCR (p < 0.001), atypical CSCR(p = 0.025), persistent subretinal fluid (SRF) (p = 0.001) and those with ORA (p < 0.001) demonstrated a trend towards severe visual loss. Prevalence of persistent SRF, recurrent episodes and ORA was significantly higher among eyes with complex CSCR (p < 0.001) while there was no difference in prevalence of resolved cases (p = 0.07), foveal involvement (p = 0.28) and MNV (p = 0.45) between simple and complex cases. Conclusion There is a strong correlation between VA and foveal involvement and ORA using the new classification. Thus, the objective parameters of the classification can be incorporated in establishing the treatment guidelines for CSCR
Multimodal Imaging Based Predictors for the Development of Choroidal Neovascularization in Patients with Central Serous Chorioretinopathy
No full textThis study evaluated predictors for choroidal neovascularization (CNV) associated with central serous chorioretinopathy (CSCR) based on multimodal imaging. A retrospective multicenter chart review was conducted on 134 eyes of 132 consecutive patients with CSCR. Eyes were classified as per the multimodal imaging-based classification of CSCR at baseline into simple/complex CSCR and primary episode/recurrent/resolved CSCR. Baseline characteristics of CNV and predictors were evaluated with ANOVA. In 134 eyes with CSCR, 32.8% had CNV (n = 44) with 72.7% having complex CSCR (n = 32), 22.7% having simple (n = 10) and 4.5% having atypical (n = 2). Primary CSCR with CNV were older (58 vs. 47, p = 0.00003), with worse visual acuity (0.56 vs. 0.75, p = 0.01) and of longer duration (median 7 vs. 1, p = 0.0002) than those without CNV. Similarly, recurrent CSCR with CNV were older (61 vs. 52, p = 0.004) than those without CNV. Patients with complex CSCR were 2.72 times more likely to have CNV than patients with simple CSCR. In conclusion, CNV associated with CSCR was more likely in complex CSCR and older age of presentation. Both primary and recurrent CSCR are implicated in CNV development. Patients with complex CSCR were 2.72 times more likely to have CNV than patients with simple CSCR. Multimodal imaging-based classification of CSCR supports detailed analysis of associated CNV
Influence of Zinc and Boron Application on Growth and Yield of French bean (Phaseolus vulgaris L.)
No full textThis study was conducted with the aim of investigating the response of boron and its interaction in maximizing the growth and yield performance of French beans. A field experiment was conducted during Rabi 2022 at Crop Research Farm, Department of Agronomy, SHUATS, Prayagraj (U.P), India. To find out the influence of Zinc and Boron on the growth and yield attributes of French bean. The experiment was laid out in Randomized Block Design with ten treatments including control each replicated thrice based on one year of experimentation. The application of Zinc 45 kg/ha-1 + Boron 0.5% @ 15 DAS, recorded significantly higher Plant height (44.00 cm), Plant dry weight (29.31 g/plant). Significantly maximum pods/plant (17.40), Seeds/pod (7.00), Seed index (44.04 g), Seed yield (1.37 t/ha), stover yield (3.21 t/ha) were recorded with the treatment of Zinc 45 kg/ha-1 + Boron 0.5% @ 15 DAS
Response of Sulphur and Molybdenum on Growth and Yield Attributes of Field Pea (Pisum sativum L.)
No full textDuring Rabi 2022, a field trial was conducted at the SHUATS Agriculture Crop Research Farm in Prayagraj. The soil in the experimental plot was sandy loamy, with a near-neutral soil response (pH 7.1), low organic carbon content (0.36%), available nitrogen (171.48 kg/ha), available phosphorus (15.2 kg/ha), and had an effective soil. K (232.5 kg/ha). The experiment was set up with a randomized block design in which he repeated nine treatments three times, based on a one-year experiment. The treatments are T1: Sulphur 20 kg/ha-1 + Mo 0.5 kg/ha-1, T2: Sulphur 20 kg/ha- 1 + Mo 1.0 kg/ha-1, T3: Sulphur 20 kg/ha-1 + Mo 1.5 kg/ha-1, T4: Sulphur 30 kg/ha-1 + Mo 0.5 kg/ha- 1, T5: Sulphur 30 kg/ha-1 + Mo 1.0 kg/ha-1, T6: Sulphur 30 kg/ha-1 + Mo 1.5 kg/ha-1, T7: Sulphur 40 kg/ha-1 + Mo 0.5 kg/ha-1, T8: Sulphur 40 kg/ha-1 + Mo 1.0 kg/ha-1, T9: Sulphur 40 kg/ha-1 + Mo 1.5 kg/ha-1, T10: Control are used. The application of Sulphur 40 kg/ha-1 + Mo 0.5 kg/ha-1, recorded significant Plant height (56.25 cm), Number of nodules/plant (9.00), Plant dry weight (22.13 g/plant), maximum pods/plant (19.00), Seeds/pod (8.21), Test weight (35.45 g), Seed yield (2.29 t/ha)
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