1,720,963 research outputs found
Frontal Trigger Site Deactivation for Migraine Surgical Therapy
No full textBackground: The World Health Organization ranked migraine as the 19th worldwide disease causing disability. Recent insights into the pathogenesis of migraine headache substantiate a neuronal hyperexcitability and inflammation involving compressed peripheral craniofacial nerves, and these trigger points can be eliminated by surgery. In this study, we report our experience with minimally invasive surgical procedures for frontal migraine headache treatment. Methods: From June 2011 to May 2019, we performed 70 frontal migraine decompression surgeries of both supratrochlear and supraorbital nerves (65 bilateral and 5 unilateral) by an endoscopic or transpalpebral approach. In 24 patients (34.2%), frontal migraine emerges as a secondary trigger point following primary occipital and/or temporal migraine surgery. Results: After a mean follow-up of 24 months (range, 3-97 months), patients with frontal trigger site migraine reported a 94% positive response to surgery (32% complete relief and 62% significant improvement); 6% had no change in their symptoms. Conclusions: Based on our experience, the operation has not caused any serious complication or side effects, and surgical decompression of supraorbital and supratrochlear nerves might be recommended to patients who suffer from a moderate to severe chronic frontal migraine not responding to conventional therapy
Surgical deactivation of occipital migraine trigger site
No full textBACKGR OUND: Following the pioneering work of Guyuron et al. in 2001, an impressive body of literature demonstrated that the inflammation of peripheral nerves caused by chronic compression from surrounding structures (e.g., muscles, blood vessels) might trigger migraines. In this study, we report our experience with a minimally invasive surgical procedure for occipital migraine headache treatment. METHODS: From June 2011 until January 2019, we performed 246 MH decompression surgeries in patients with either frontal, occipital, or temporal migraine trigger sites. Among them, 130 surgeries were performed to treat occipital migraine (90 bilateral and 40 unilateral). In 108 occipital migraines, we found a dilated occipital artery in close connection with the greater occipital nerve (GON) and we ligated the vessel without any other surgical manoeuvres. R ESULTS: After a mean follow-up of 21 months (range: 3-67 months), patients with occipital migraine had positive response in 94.9% (86.8% complete relief and 8.1% significant improvement), and 5.1% did not get any better. CONCLUSIONS: Occipital migraine is a common and debilitating condition that can be treated successfully with surgery. According to our experience, a dilated occipital artery is usually responsible for nerve compression, mostly the greater occipital nerve. Clinical outcome of our surgical procedure based on artery ligation seems to prove the validity of this hypothesis
Double free transverse upper gracilis flap breast reconstruction: advantages of using LD flap as a salvage solution
Full text linkThe lower abdominal tissue is still the most common donor site used for free autologous breast reconstruction. If this site is not available, multiple secondary choices exist. The transverse upper gracilis flap is a valuable choice and it can be used alone or in combination with other flaps. We present a case of a 49-year-old patient who underwent delayed unilateral breast reconstruction by using a double transverse upper gracilis flap. Due to venous thrombosis, the flap inserted in the lower pole was lost. We managed the complication tailoring a latissimus dorsi flap to close the defect. We reported the advantages of the latissimus dorsi flap as a rescue solution and its superior aesthetic result in this particular case. Breast reconstruction with transverse upper gracilis flap in addition to the latissimus dorsi flap allowed us to obtain an adequate breast volume avoiding the use of breast implants as desired by the patient. We thought that the double free transverse upper gracilis flap for delayed, or immediate unilateral reconstruction of small to moderate breast could be a valuable option to avoid the use of implants and when abdominal tissue is not available. However, it should be taken into consideration the shortness of the transverse upper gracilis pedicle, the necessity to perform a retrograde flow anastomosis at the level of the internal mammary, and the discrepancy of skin color tones with the receiving site. The latissimus dorsi flap was an excellent rescue solution and put in evidence the aesthetic superiority of this flap compared to the transverse upper gracilis flap
Eccrine porocarcinoma: case report and review of the literature
No full textEccrine porocarcinoma is a rare skin cancer that originates from the acrosyringium of eccrine sweat glands. From the clinical point of view the differential diagnosis with other skin cancers such as basal cell carcinoma and squamous cell carcinoma it is often impossible, only the histopathologic features can lead to the definitive diagnosis. Eccrine porocarcinoma can arise from a previous poroma or de novo, it may recur after surgical excision and cause lymph node and visceral metastasis. There are no international guidelines for treatment or follow-up of patients. The aim of this work was to present a rare case of eccrine porocarcinoma of the scalp successfully treated in our clinic and to extrapolate from the international literature the main clinical and histopathological features of eccrine porocarcinoma and the various experiences regarding the types of treatment
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Quality of life in post-bariatric surgery patients undergoing aesthetic abdomi-noplasty: Our experience
No full textBackground/aim of the study: Aesthetic post-bariatric surgery abdominoplasty aims to reshape the abdominal wall in order to improve the patient's appearance and self-image. Patients who have undergone this surgery report significant improvements in self-esteem and quality of life. Material and Methods: The authors evaluated the quality of life in 30 patients (22 women and 8 men) aged 24-79 years (mean age: 50.5 years) undergoing aesthetic post-bariatric surgery abdominoplasty between January 2012 and September 2015. Quality of life and body image were measured with two self-report questionnaires: a basic questionnaire (BQ) and the Body Image As-sessment-Obesity (BIA-O). Results: At the end of the study, 58% of patients reported complete satisfaction with the aesthetic results, while 23% of patients expressed dissatisfaction with the surgical scars. Analysis of the responses to the BIA-O, showed that patients had a better and slimmer body image perception after surgery than they had preoperatively. Conclusion:Although our study sample was small, we could demonstrate that most patients undergoing aesthetic post-bariatric surgery abdominoplasty experience improvement in body image perception and quality of life
Adipose-derived stem cells as a novel anti-aging therapy in cosmetic surgery: A concise review
No full textFacial aging is a complex process and often poses a challenge for plastic and aesthetic surgeons. Injectable fillers and autologous adipose tissue are widely used for the restoration of soft tissue volume. However, lipotransfer currently lacks standardization and its unpredictable reabsorption rate remains an unresolved issue. Adipose-derived stem cells (ASCs) are multipotent mesenchymal stem cells that could be responsible for the main rejuvenation capabilities of fat grafts. Currently, ASCs are administered in conjunction with autologous fat, while injectable vehicles such as hyaluronic acid, or other injectable biomaterials, are under study for the treatment of facial aging with promising results. Indeed, bioengineered fillers are at a very early stage of development, and could be further developed as semi-permanent fillers with biological properties of engrafted adipose tissue. ASCs could emerge as an effective and novel anti-aging therapeutic agent. However, extensive analysis of their actual effectiveness and mechanism of action are required
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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