1,720,977 research outputs found
Answer to: Commentary on “Can AI Answer My Questions? Utilizing Artificial Intelligence in the Perioperative Assessment for Abdominoplasty Patients”
No full textThe authors respond to the Commentary on “Can AI Answer My Questions? Utilizing Artificial Intelligence in the Perioperative Assessment for Abdominoplasty Patients” by analyzing the insights proposed by the authors. AI is already being utilized in various surgical aspects, including patient assessment, surgical planning, and intraoperative decision-making. 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 Effect of Drains and Compressive Garments Versus Progressive Tensioning Sutures on Seroma Formation in Abdominoplasty: A New Perspective for Abdominoplasty Procedure?
No full textAuthors comment on the paper “The effect of drains and compressive garments versus progressive tensioning sutures on seroma formation in abdominoplasty” written by Brown et al in Aesthetic Plastic Surgery. Although the authors present interesting results on the effectiveness of progressive tensioning sutures proposed originally by Pollok and Pollok, we express some considerations about the analyzed data and patients, hoping in a new research extending these findings to include both aesthetic and post-bariatric abdominoplasty patients, evaluating the effectiveness of these sutures in varied contexts. 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 Table of Contents or online Instructions to Authors www.springer.com/00266
Enhancing Hand Fracture Care: A Prospective Study of Artificial Intelligence Application With ChatGPT
Full text linkPurpose: The integration of artificial intelligence and machine learning technologies into the medical field has brought about remarkable advancements, particularly in the domain of clinical decision support systems. However, it is uncertain how they will perform as clinical decision-makers. Methods: This prospective cohort study evaluates the potential of incorporating ChatGPT-4 plus into the management of subcapital fifth metacarpal fractures. The treatment recommendations provided by ChatGPT-4 plus were compared with those of the two control groups—the attending clinic plastic surgeon and an independent expert panel. The primary outcome measures, operative or conservative, were compared between the groups. Intraclass correlation of 0.61 infers moderate reliability in the consistency of recommended management plans across all groups. Results: Key predictors for opting for operative management, regardless of the decision-maker, included clinical signs of scissoring, extension deficit, and radiographic evidence of intra-articular extension. Conclusions: These findings support the potential for artificial intelligence applications in enhancing diagnostic and treatment decisions. Type of study/level of evidence: Therapeutic IV. © 2024 The Author
Treatment of Atrophic Acne Scarring with Fractional Microplasma Radiofrequency: A Multicentric Experience
Full text linkBackground: Atrophic scarring is a severe form-disfiguring sequela of acne, which can lead to negative effect on patients' life. Fractional microplasma radiofrequency (RF) has emerged as a promising modality, leveraging dermal fibroblast remodeling to enhance aesthetic results for scars and hyperpigmentation. This study evaluates the efficacy and safety of high-power fractional microplasma RF for atrophic acne scars, considering patient tolerance to procedural discomfort. Methods: In this prospective study, 95 Chinese patients with atrophic facial acne scars underwent three sessions of fractional microplasma RF treatment, with assessments at 1, 3, and 6 months post-treatment. Patients were categorized based on treatment power: Group A (50-70 W) and Group B (70-85 W). Efficacy was determined by three independent dermatologists using digital photographs and Echelle d'Evaluation Clinique des Cicatrices d'Acn & eacute; (ECCA) scores, and patient-reported outcomes gauged satisfaction levels. Results: Eighty-six patients completed the study. Significant improvements were observed, with a reduction in ECCA scores from 107.21 to 42.27 (P<0.05), demonstrating notable scar amelioration across both groups, albeit with a superior outcome in Group B. All patients experienced transient side effects such as pain, erythema, and edema, deemed tolerable with no long-term adverse effects reported. The treatment was well-received, with high satisfaction rates, underscoring its efficacy and acceptable safety profile. Conclusion: Fractional microplasma RF therapy, particularly at higher power settings, is an effective and safe option for treating atrophic acne scars, offering significant aesthetic improvement with manageable discomfort. This modality presents a valuable addition to acne scar management strategies, especially for patients with darker skin tones seeking minimal downtime and reduced risk of hyperpigmentation. (c) 2024 The Author(s). Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/
Utilizing GPT-4 and generative artificial intelligence platforms for surgical education: an experimental study on skin ulcers
No full textBackgroundThe advancement of artificial intelligence (AI), specifically Generative Adversarial Networks (GANs), offers exciting possibilities for the enhancement of medical education, with its image-generation capabilities becoming a topic of interest. This novel study evaluates the aptitude of combining a large language model, ChatGPT, with GANs DALL-E 2, Midjourney, and Blue Willow in producing authentic images of ulcers, with a goal to enrich educational resources for surgery.MethodsFirst, ChatGPT-4 was prompted with definitions of different skin ulcers, and its response was inputted into the GAN models. Generated AI images were evaluated by four board-certified plastic surgeons and three plastic surgeon residents with extensive experience using a Likert scale.ResultsAmong the three GANs, only DALL-E showed an acceptable level of accuracy, portraying the unique characteristics of each ulcer type. However, it cannot replace conventional patient photographs in terms of authenticity and educational value. Despite presenting aesthetically pleasing images, Midjourney and Blue Willow produced highly stylized, exaggerated features unsuitable for clinical education.ConclusionsDespite these shortcomings, the future of AI-generated images remains promising, given the continuous progress of technology, in augmenting traditional medical education methodologies.Level of evidence: Not gradable.ConclusionsDespite these shortcomings, the future of AI-generated images remains promising, given the continuous progress of technology, in augmenting traditional medical education methodologies.Level of evidence: Not gradable
Cutaneous amyloidosis mimicking basal cell carcinoma: a case series and literature review
No full textBackground: Amyloidosis is characterized by extracellular amyloid protein deposi - tion. When amyloidosis intersects with basal cell carcinoma (BCC ), it introduces complex di - agnostic challenges. This study explored the overlap between primary localized cutaneous amyloidosis (PLCA ) and BCC, examining amyloid deposits in BCC, systemic amyloidosis risk in PLCA, and various treatment methods. Methods: Two case studies were discussed, followed by a literature review, in which PubMed, Web of Science, EMBASE, and the Cochrane Library databases were utilized. The search, cov - ering studies from infinity up to January 2024, focused on "cutaneous amyloidosis," "basal cell carcinoma," and related terms. Articles in English detailing the clinical presentation, diag - nostic methods, treatment, and outcomes of cutaneous amyloidosis mimicking BCC were in - cluded. Data extraction and synthesis were performed by two independent reviewers. Case Series: This study highlighted two cases exemplifying the complexity of diagnosing BCC and PLCA. The first case (a 64 -year -old with a nodule on the cheek ) and the second (a 67 -year - old with a nodular lesion on the upper lip cheek ) were initially suspected as BCC and were later identified as PLCA upon histopathological examination. Discussion: The diagnosis of amyloidosis within BCC nodules remains a diagnostic challenge. Although their coexistence is relatively prevalent, their local recurrence rates remain deba - table. Various diagnostic and therapeutic approaches have been suggested, such as topical creams and phototherapy. However, none have garnered conclusive and consistent evidence to establish reliable clinical application. Conclusion: The findings emphasized the importance of considering alternative pathologies in differential diagnoses. Future research should focus on understanding systemic amyloidosis risks and optimizing care for both conditions. (c) 2024 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons
Evaluating Artificial Intelligence's Role in Teaching the Reporting and Interpretation of Computed Tomographic Angiography for Preoperative Planning of the Deep Inferior Epigastric Artery Perforator Flap
Full text linkBackground: Artificial intelligence (AI) has the potential to transform preoperative planning for breast reconstruction by enhancing the efficiency, accuracy, and reliability of radiology reporting through automatic interpretation and perforator identification. Large language models (LLMs) have recently advanced significantly in medicine. This study aimed to evaluate the proficiency of contemporary LLMs in interpreting computed tomography angiography (CTA) scans for deep inferior epigastric perforator (DIEP) flap preoperative planning. Methods: Four prominent LLMs, ChatGPT-4, BARD, Perplexity, and BingAI, answered six questions on CTA scan reporting. A panel of expert plastic surgeons with extensive experience in breast reconstruction assessed the responses using a Likert scale. In contrast, the responses’ readability was evaluated using the Flesch Reading Ease score, the Flesch-Kincaid Grade level, and the Coleman-Liau Index. The DISCERN score was utilized to determine the responses’ suitability. Statistical significance was identified through a t-test, and P-values < 0.05 were considered significant. Results: BingAI provided the most accurate and useful responses to prompts, followed by Perplexity, ChatGPT, and then BARD. BingAI had the greatest Flesh Reading Ease (34.7±5.5) and DISCERN (60.5±3.9) scores. Perplexity had higher Flesch-Kincaid Grade level (20.5±2.7) and Coleman-Liau Index (17.8±1.6) scores than other LLMs. Conclusion: LLMs exhibit limitations in their capabilities of reporting CTA for preoperative planning of breast reconstruction, yet the rapid advancements in technology hint at a promising future. AI stands poised to enhance the education of CTA reporting and aid preoperative planning. In the future, AI technology could provide automatic CTA interpretation, enhancing the efficiency, accuracy, and reliability of CTA reports
Atypical Mycobacterium ulcerans Infection with Skip Lesions in a 68-Year-Old Male: A Rare Case and Comprehensive Literature Review
No full textBackground/Objectives: Mycobacterium ulcerans causes Buruli ulcers, typically manifesting as a single progressive necrotizing skin lesion. Rarely, non-contiguous “skip lesions” occur, complicating diagnosis and management. This report describes an atypical case and reviews similar presentations to emphasize early recognition and combined therapeutic strategies. Methods: A systematic literature review was performed using PubMed, Embase, Cochrane Library, Google Scholar, and Scopus databases until December 2024, focusing on cases involving skip lesions. Additionally, a detailed clinical case of a 68-year-old male from Mornington Peninsula, Australia, presenting skip lesions from the distal leg to the proximal knee was documented, including diagnostic PCR testing, surgical interventions, and antibiotic treatments. Results: Twelve studies were identified, totaling 1828 cases with 1179 exhibiting skip lesions. The majority achieved successful outcomes through combined antibiotic (rifampicin and clarithromycin) and surgical management. The reported case initially underwent surgical excision without antibiotics, leading to recurrence. Subsequent comprehensive management combining additional surgical debridement and adjusted antibiotics successfully resolved the infection. Conclusions: Although rare, skip lesions significantly complicate the clinical management of Buruli ulcers. Early diagnosis and a multidisciplinary approach integrating surgical debridement and antibiotic therapy are critical for optimal outcomes and minimizing recurrence risks
Myopericytoma Masquerading as Dupuytren’s Disease: A Case Report and Systematic Literature Review
No full textBackground: Myopericytoma is a rare benign vascular tumour characterised by concentric spindle cell proliferation around blood vessels, often misdiagnosed due to its resemblance to other soft tissue masses. Dupuytren’s disease (DD), a fibroproliferative disorder of the palmar fascia, causes progressive contractures, typically affecting the ring and little fingers. While these conditions are well-documented individually, their coexistence in the same region is rare and diagnostically challenging. Case Presentation: This report highlights a 67-year-old male with longstanding DD and a recurrent palmar mass initially attributed to fibrosis. Magnetic resonance imaging revealed hallmark vascular features suggestive of myopericytoma, confirmed by histopathological analysis showing spindle cell proliferation and immunohistochemical positivity for alpha-smooth muscle actin and h-caldesmon. Concurrent DD, characterised by fibrosis and activated myofibroblasts, further complicated the clinical picture. Methodology: PubMed, Scopus, Web of Science, and Embase databases were searched from January 1901 to December 2024, and 20 studies were found, reporting 41 cases of myopericytoma in hand and upper extremity. Histopathological analysis consistently showed spindle cell proliferation and smooth muscle actin positivity. Coexistence with DD was rare, highlighting the need for detailed imaging and histological evaluation for accurate diagnosis. Conclusions: This case emphasises the complexity of differentiating overlapping pathologies. Surgical excision of myopericytoma and tailored DD management yielded favourable outcomes. Further research into shared fibroinflammatory pathways, including tumour necrosis factor-alpha and interleukin-6, may enhance diagnostic accuracy and treatment strategies for overlapping conditions
Impact of nutrition on skin wound healing and aesthetic outcomes: A comprehensive narrative review
Full text linkBackground: While current wound treatment strategies often focus on antimicrobials and topical agents, the role of nutrition in wound healing and aesthetic outcomes is crucial but frequently overlooked. This review assesses the impact of specific nutrients and preoperative nutritional status on surgical outcomes. Methods: A comprehensive search was conducted in PubMed, Scopus, Web of Science, and the Cochrane Library, from the inception of the study to October 2023. The study focused on the influence of macronutrients and micronutrients on aesthetic outcomes, the optimization of preoperative nutritional status, and the association between nutritional status and postoperative complications. Inclusion criteria were English language peer-reviewed articles, systematic reviews, meta-analyses, and clinical trials related to the impact of nutrition on skin wound healing and aesthetic outcomes. Exclusion criteria included non-English publications, non-peer-reviewed articles, opinion pieces, and animal studies. Results: Omega-3 fatty acids and specific amino acids were linked to enhanced wound-healing and immune function. Vitamins A, B, and C and zinc positively influenced healing stages, while vitamin E showed variable results. Polyphenolic compounds showed anti-inflammatory effects beneficial for recovery. Malnutrition was associated with increased postoperative complications and infections, whereas preoperative nutritional support correlated with reduced hospital stays and complications. Conclusion: Personalized nutritional plans are essential in surgical care, particularly for enhanced recovery after surgery protocols. Despite the demonstrated benefits of certain nutrients, gaps in research, particularly regarding elements such as iron, necessitate further studies. Nutritional assessments and interventions are vital for optimal preoperative care, underscoring the need for more comprehensive guidelines and research in nutritional management for surgical patients
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