The Anterior SMAS Approach for Facelifting and for Buccal Fat Pad Removal

Abstract

Having performed numerous varieties of SMAS advancement including: plication, resection, flap elevation with variable anterior deep dissection, the author has developed a direct approach to the mobile anterior SMAS which allows correction of midface descent, modest elevation of the modiolus, jawline correction, and, where indicated, direct access for buccal fat pad resection.

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 http://ift.tt/18t7xNj.

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Systematic Review of Quality of Patient Information on Phalloplasty in the Internet

Abstract

Background

An increasing number of patients, considering aesthetic surgery, use Internet health information as their first source of information. However, the quality of information available in the Internet on phalloplasty is currently unknown. This study aimed to assess the quality of patient information on phalloplasty available in the Internet.

Methods

The assessment of the Web sites was based on the modified Ensuring Quality Information for Patients (EQIP) instrument (36 items). Three hundred Web sites were identified by the most popular Web search engines.

Results

Ninety Web sites were assessed after, duplicates, irrelevant sources and Web sites in other languages rather than English were excluded. Only 16 (18%) Web sites addressed >21 items, and scores tended to be higher for Web sites developed by academic centers and the industry than for Web sites developed by private practicing surgeons. The EQIP score achieved by Web sites ranged between 4 and 29 of the total 36 points, with a median value of 17.5 points (interquartile range, 13–21). The top 5 Web sites with the highest scores were identified.

Conclusions

The quality of patient information on phalloplasty in the Internet is substandard, and the existing Web sites present inadequate information. There is a dire need to improve the quality of Internet phalloplasty resources for potential patients who might consider this procedure.

Level of Evidence IV

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 http://ift.tt/18t7xNj.

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Re: Correction of Rhytides, Peau d’Orange and Thin Dermis of the Face by Neocollagenesis Using Novel Collagen Stimulating Slurry Protocol

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Fetal Tobacco Smoke Exposure in the Third Trimester of Pregnancy Is Associated with Atopic Eczema/Dermatitis Syndrome in Infancy

Pediatric Allergy, Immunology, and Pulmonology , Vol. 0, No. 0.


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TERT Promoter Mutations Were Not Found in Papillary Thyroid Microcarcinomas That Showed Disease Progression on Active Surveillance

Thyroid , Vol. 0, No. 0.


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Using P16 Immunohistochemistry to Classify Morphologic Cervical Intraepithelial Neoplasia 2: Correlation of Ambiguous Staining Patterns with HPV Subtypes and Clinical Outcome

Publication date: Available online 11 July 2017
Source:Human Pathology
Author(s): Yuxin Liu, Mahfood Alqatari, Kieran Sultan, Fei Ye, Dana Gao, Keith Sigel, David Zhang, Tamara Kalir
P16^INK4a immunohistochemistry (IHC) is widely used to facilitate the diagnosis of human papillomavirus (HPV)-associated cervical precancerous lesions. While most p16 results are distinctly positive or negative, certain ones are ambiguous: they meet some but not all requirements for the “block-positive” pattern. It is unclear whether ambiguous p16 immunoreactivity indicates oncogenic HPV infection or risk of progression. Herein, we compared HPV genotypes and subsequent High-grade Squamous Intraepithelial Lesion (HSIL) outcomes among 220 cervical biopsies with a differential diagnosis of Cervical Intraepithelial Neoplasia 2 (CIN 2) based on hematoxylin and eosin morphology and varying degrees of p16 immunoreactivity. P16 results were classified as block-positive (n=40, 18%), negative (n=130, 59%), or ambiguous (n=50, 23%), a category we further grouped into three patterns: strong/basal (n=18), strong/focal (n=15), and weak/diffuse (n=17). 70% of ambiguous p16 lesions were negative for the most common low- and high-risk HPV types; the remaining 30% were positive for HPV 16, 18, 45, 58, 59, or 66. Three patterns revealed comparably low HPV detection rates (28%, 27% and 35%). During 12-month surveillance, HSILs were detected in 35% of the p16 block-positive group, 1.5% of negative group, and 16% of the ambiguous group. The accuracy of ambiguous p16 immunoreactivity in predicting oncogenic HPV and HSIL outcome is significantly lower than that of the block-positive pattern but greater than negative staining. Specific guidelines for this intermediate category should prevent diagnostic errors and help implement p16 IHC in general practice.



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Perineural Invasion by Prostate Cancer on MR/US Fusion Targeted Biopsy is Associated with Extraprostatic Extension and Early Biochemical Recurrence after Radical Prostatectomy

Publication date: Available online 11 July 2017
Source:Human Pathology
Author(s): Matthew Truong, Soroush Rais-Bahrami, Jeffrey W. Nix, Edward M. Messing, Hiroshi Miyamoto, Jennifer B. Gordetsky
In recent years, multiparametric magnetic resonance imaging (MRI) and MR/ultrasound (US) fusion targeted biopsy (TB) have become more widely adopted to aid in prostate cancer (PCa) detection. Previously, TB has been found to increase the yield of clinically significant PCa and is more likely to sample the index tumor compared to traditional 12-core extended sextant biopsies. Currently the prognostic significance of perineural invasion (PNI) when identified on TB (PNI-TB) is unknown. We identified 95 men at two tertiary referral centers who underwent TB followed by radical prostatectomy between January 2014 and January 2017. Clinical, radiological, and pathological variables were retrospectively reviewed. PNI was identified on TB in 27/95 (28.4%) patients. On multivariable logistic regression, independent predictors of extraprostatic extension were prostate specific antigen (PSA), TB maximum % core involvement, and PNI-TB (all P<.05). Furthermore, Kaplan–Meier analysis demonstrated that PNI-TB was associated with early biochemical recurrence events within 12months after prostatectomy (log rank P=.049). Given the increasing adoption of TB for PCa detection in clinical practice, PNI-TB may be useful for PCa risk stratification.



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