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The Authors Reply [Comment]

Junewicz, Alexandra; Youngner, Stuart J
PMID: 26556136
ISSN: 1552-146x
CID: 2699972

Patient-satisfaction surveys on a scale of 0 to 10: improving health care, or leading it astray?

Junewicz, Alexandra; Youngner, Stuart J
Patient-satisfaction surveys can call attention to the importance of treating patients with dignity and respect, but good ratings depend more on manipulable patient perceptions than on good medicine. In fact, the pressure to get good ratings can lead to bad medicine.
PMID: 25753653
ISSN: 0093-0334
CID: 2699982

Primary cutaneous vs. parotid mucoepidermoid carcinoma of the scalp: A case report [Case Report]

Junewicz, Alexandra; Heaphy, John; Lavertu, Pierre; Wasman, Jay; Becker, Devra
Primary cutaneous mucoepidermoid carcinoma remains a rare occurrence. This is the first report of a case of primary cutaneous mucoepidermoid carcinoma originating on the scalp and subsequently metastasizing to the parotid gland. The patient was a 53-year-old female who presented with a purple mass on her scalp since 5 months prior to examination. Histopathology revealed nests and islands of atypical epithelioid cells with pleomorphism, medium to prominent nucleoli, and scattered mucin deposition highlighting with a mucicarmine stain. The atypical cells demonstrated intravascular involvement. These findings were compatible with metastatic adenocarcinoma. Later, fine needle aspiration of the patient's parotid lesion revealed malignant cells from a poorly differentiated carcinoma that appeared similar to the patient's previously excised scalp lesion. In addition to summarizing this patient's presentation, clinical course, and management, we discuss the diagnostic challenges posed by this atypical presentation. Primary cutaneous mucoepidermoid carcinoma should be considered in the differential diagnosis of patients presenting with a scalp mass. Moreover, patients with primary cutaneous mucoepidermoid carcinoma originating on the scalp should be evaluated for possible metastases.
PMID: 25708819
ISSN: 1532-818x
CID: 3115772

Q: Do patients who received only two doses of hepatitis B vaccine need a booster?

Junewicz, Alexandra; Brateanu, Andrei; Nielsen, Craig
PMID: 24891535
ISSN: 1939-2869
CID: 2700002

The temporoparietal adipofascial flap for the correction of recurrent idiopathic enophthalmos [Case Report]

Doumit, Gaby D; Junewicz, Alexandra; Yaremchuk, Michael
Enophthalmos, the posterior displacement of a normal-size ocular globe relative to the orbital cavity, is usually repaired using autogenous grafts or alloplastic materials. We present the case of a 40-year-old man with bilateral idiopathic enophthalmos whose symptoms recurred 8 years after initial successful surgical repair. We describe the successful and safe use of a bilateral temporoparietal adipofascial flap in the treatment of recurrent idiopathic enophthalmos.
PMID: 24621720
ISSN: 1536-3732
CID: 3118852

Of playoff tickets and preschools: health care advertising and inequality [Comment]

Junewicz, Alexandra
PMID: 24592846
ISSN: 1536-0075
CID: 2700012

Shackled: providing health care to prisoners outside of prison [Comment]

Junewicz, Alexandra
PMID: 24978403
ISSN: 1536-0075
CID: 2699992

Intraoperative anatomical variations during greater occipital nerve decompression

Junewicz, Alexandra; Katira, Kris; Guyuron, Bahman
OBJECT/OBJECTIVE:A study was conducted to elucidate anatomical variations of the GON and surrounding occipital tissues. METHODS:Anatomical and surgical variations were prospectively recorded for 272 patients who underwent greater occipital nerve (GON) decompression by a single surgeon between 2003 and 2012. Data collection was performed intraoperatively and specifically for the purposes of this study. Documented anatomical variations of the GON and surrounding occipital region included the extension of trapezius musculature to the midline, abnormal lymph nodes, and GON branching. Necessary variations in the surgical procedure were also noted, including resection of a lateral portion of semispinalis capitis muscle and occipital arterectomy. RESULTS:The GON pierced the semispinalis muscle in all patients bilaterally. The extension of trapezius musculature to the midline was discovered in 67.3 percent of patients and lymph node enlargement was discovered in 1.5 percent of patients. Branching of the GON was noted in 7.4 percent of patients and muscles or vessels between GON branches were noted in 3.7 percent of patients. Occipital arterectomy was required in 64.0 percent of patients and resection of a lateral segment of semispinalis muscle was required in 10.7 percent of patients. CONCLUSIONS:The new anatomical variations described in this study improve understanding of the intraoperative anatomy of the occipital region and prevent difficulty in finding the GON due to dissection in the wrong plane, ensuring that MH patients receive maximal benefit from surgical treatment.
PMID: 23810603
ISSN: 1878-0539
CID: 3123172