Faculty Bibliography
Searched for:
school:SOM
Department/Unit:Plastic Surgery
Total Results:
5786
Journal of biomedical materials research. Part B, Applied biomaterials. 2025:113(6).DOI: 10.1002/jbm.b.35595
Three-Dimensional Assessment of Internal and Marginal Fit of Provisional Crowns Fabricated Using 3D-Printing Technology
To evaluate the effect of silanized filler particles and blue light-sensitive photoinitiator system on the internal and marginal fit of 3D printed resin crowns as well as the volume of provisional cement space. This study evaluated three commercially available 3D-printing resins (Smart Print Temp/SP, Resilab 3D Temp/RL, and Cosmos Temp/CT). The experimental groups consisted of the addition of 30% by weight (30 wt%) of silanized filler particles and a blue light-sensitive Ternary Photoinitiator System (TPS). Samples were printed for each group (n = 10) and evaluated for internal and marginal fit and volume of cement space using a micro-computed tomography (μCT). The obtained data were analyzed by Generalized Linear Models (α = 0.05). The incorporation of TPS and filler particles to the 3D printing resins altered the internal fit and the marginal fit, increasing the cement space at the occlusal face and decreasing the cement space of the axial walls for all tested materials. The volume was significantly affected too, especially for RL and CT. Internal misfit was significantly higher with the addition of TPS, and marginal misfit with the addition of filler particles. In general, the incorporation of TPS and 30 wt% of filler particles promoted an increase in the volume of cement space, as well as an increase in occlusal space and marginal space and a decrease in the axial walls' spaces.
PMID: 40387426
ISSN: 1552-4981
CID: 5852502
Decoding Tertiary Lymphoid Structures in Hidradenitis Suppurativa: New Mechanistic Insights
PMID: 40152835
ISSN: 1523-1747
CID: 5817512
Is a Seroma the "Kiss of Death" in Prepectoral Tissue Expander Reconstruction?
BACKGROUND/UNASSIGNED:A seroma following prepectoral tissue expander (TE) reconstruction often begets other complications, which may compromise the reconstruction. This study investigated the association between seroma and subsequent complications. METHODS/UNASSIGNED:All consecutive prepectoral TE reconstructions performed between March 2017 and December 2022 at a single center were reviewed. Demographics, operative characteristics, and complications data were extracted for all patients and analyzed. RESULTS/UNASSIGNED:< 0.01). CONCLUSIONS/UNASSIGNED:Although causality cannot be determined, our data suggests that seroma may be the "kiss of death" in prepectoral TE reconstruction because half of all breasts with a seroma went on to develop other complications.
PMCID:12144650
PMID: 40487834
ISSN: 2169-7574
CID: 5868962
Patient reliability and surgical decision-making biases amongst hand surgeons
The perception of patient reliability may create surgical decision-making biases amongst hand surgeons. In this study, anonymous surveys were distributed to hand surgeons to understand how patient 'reliability' is defined and how it alters treatment decisions. Participants rated the importance of patient factors in assessing reliability, then completed fictional clinical vignettes detailing histories of patients undergoing elective surgery. Suspected substance usage and history of mental illness were rated as important factors in determining reliability, while gender and race were rated as not important. Physicians were significantly less likely to recommend surgery and exhibited less confidence in their recommendations when presented with a patient with a history of mental illness (p < 0.001) or suspected substance usage (p = 0.003). These findings suggest that while race and gender may not explicitly impact surgical decision-making, biases related to mental illness and substance use do affect treatment decisions and confidence levels. Recognizing these biases is critical for ensuring equitable care, and future efforts should explore strategies to mitigate their impact on surgical recommendations. Level of evidence: IV.
PMID: 40439076
ISSN: 2043-6289
CID: 5854712
Global, Regional, and National Burden of Nontraumatic Subarachnoid Hemorrhage: The Global Burden of Disease Study 2021
IMPORTANCE/UNASSIGNED:Nontraumatic subarachnoid hemorrhage (SAH) represents the third most common stroke type with unique etiologies, risk factors, diagnostics, and treatments. Nevertheless, epidemiological studies often cluster SAH with other stroke types leaving its distinct burden estimates obscure. OBJECTIVE/UNASSIGNED:To estimate the worldwide burden of SAH. DESIGN, SETTING, AND PARTICIPANTS/UNASSIGNED:Based on the repeated cross-sectional Global Burden of Disease (GBD) 2021 study, the global burden of SAH in 1990 to 2021 was estimated. Moreover, the SAH burden was compared with other diseases, and its associations with 14 individual risk factors were investigated with available data in the GBD 2021 study. The GBD study included the burden estimates of nontraumatic SAH among all ages in 204 countries and territories between 1990 and 2021. EXPOSURES/UNASSIGNED:SAH and 14 modifiable risk factors. MAIN OUTCOMES AND MEASURES/UNASSIGNED:Absolute numbers and age-standardized rates with 95% uncertainty intervals (UIs) of SAH incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) as well as risk factor-specific population attributable fractions (PAFs). RESULTS/UNASSIGNED:In 2021, the global age-standardized SAH incidence was 8.3 (95% UI, 7.3-9.5), prevalence was 92.2 (95% UI, 84.1-100.6), mortality was 4.2 (95% UI, 3.7-4.8), and DALY rate was 125.2 (95% UI, 110.5-142.6) per 100 000 people. The highest burden estimates were found in Latin America, the Caribbean, Oceania, and high-income Asia Pacific. Although the absolute number of SAH cases increased, especially in regions with a low sociodemographic index, all age-standardized burden rates decreased between 1990 and 2021: the incidence by 28.8% (95% UI, 25.7%-31.6%), prevalence by 16.1% (95% UI, 14.8%-17.7%), mortality by 56.1% (95% UI, 40.7%-64.3%), and DALY rate by 54.6% (95% UI, 42.8%-61.9%). Of 300 diseases, SAH ranked as the 36th most common cause of death and 59th most common cause of DALY in the world. Of all worldwide SAH-related DALYs, 71.6% (95% UI, 63.8%-78.6%) were associated with the 14 modeled risk factors of which high systolic blood pressure (population attributable fraction [PAF] = 51.6%; 95% UI, 38.0%-62.6%) and smoking (PAF = 14.4%; 95% UI, 12.4%-16.5%) had the highest attribution. CONCLUSIONS AND RELEVANCE/UNASSIGNED:Although the global age-standardized burden rates of SAH more than halved over the last 3 decades, SAH remained one of the most common cardiovascular and neurological causes of death and disabilities in the world, with increasing absolute case numbers. These findings suggest evidence for the potential health benefits of proactive public health planning and resource allocation toward the prevention of SAH.
PMID: 40406922
ISSN: 2168-6157
CID: 5852552
Swallowing Function After Pioneering Partial Face and Whole Eye Transplant: Clinical Insights
PURPOSE/UNASSIGNED:There is limited literature reporting swallowing outcomes in the pre- and postoperative period for patients undergoing facial transplantation. This case report aims to utilize a combination of objective and patient-reported outcome measures to highlight swallowing improvements following the world's first face with whole-eye transplantation. METHOD/UNASSIGNED:Outcome measures in jaw range of motion, anterior containment, texture progression, airway protection, and pharyngeal swallow function were collected pretransplantation by two speech-language pathologists (SLPs) and at multiple postoperative visits after the procedure was completed. Specific outcome measures included the Gothenburg Trismus Questionnaire, Maximal Incisor Opening, Modified Teachers Drooling Scale, Functional Oral Intake Scale, Eating Assessment Tool-10, The Penetration-Aspiration Scale, and the Modified Barium Swallow Study Impairment Profile. Measures were then compared over a 1-year time period to assess changes in swallow function. RESULTS/UNASSIGNED:Improvements in jaw range of motion, anterior containment, and airway protection were observed. The patient's stated goal of returning to full PO diet following face transplant was achieved within 1 year. CONCLUSIONS/UNASSIGNED:Swallowing and trismus outcome measures are an important tool for monitoring progress along a patient's recovery journey, especially following unique procedures such as face transplantation. Based on this single patient case study, facial transplantation can lead to improvements in both objective and patient-reported outcomes. Future goals for research should continue to explore this unique population due to the limited literature available for SLPs, as well as include development of valid and reliable assessment tools specific to the face transplantation population.
PMID: 40403408
ISSN: 1558-9110
CID: 5853442
How Accurate and Effective Are Non-image-guided Thumb Basal Joint Injections When Performed by Experienced Fellowship-trained Hand Surgeons?
BACKGROUND:Corticosteroid injections are widely used for treating thumb carpometacarpal (CMC) arthritis, yet the accuracy of non-image-guided injections in expert hands is uncertain, with prior studies reporting intraarticular placement in about 60% of thumbs when performed by physicians with different levels of training. Despite their common use, there is a need to assess both the accuracy and the short-term clinical efficacy of these injections, particularly when performed without image guidance by fellowship-trained hand surgeons. QUESTIONS/PURPOSES:(1) What is the accuracy of thumb CMC injections performed without image guidance by fellowship-trained hand surgeons in an office setting? (2) What is the short-term efficacy of thumb CMC injections performed without image guidance? METHODS:We prospectively enrolled 33 patients with a mean ± SD age of 63 ± 12 years, 76% (25) of whom were female, with symptoms of basal joint arthritis that persisted despite conservative treatment, and we administered 1.5-mL corticosteroid injections without image guidance. We used descriptive statistics to analyze the outcomes, which included VAS, QuickDASH (Q-DASH), and Thumb Disability Examination (TDX) scores. Minimum clinically important differences (MCIDs) were defined as 0.9 points for the VAS, 18 points for Q-DASH, and 17 points for TDX. RESULTS:Of the 33 injections analyzed, 79% (26) were intraarticular. At 6 weeks, patients reported a mean improvement of 22 points in QuickDASH, 24 points in TDX, and 4 points in VAS scores. Importantly, 73% (24 of 33), 55% (18 of 33), and 82% (27 of 33) of the patients achieved the MCID in the patient-reported outcomes, respectively, suggesting that even without image guidance, corticosteroid injections can provide effective short-term relief for thumb CMC arthritis. CONCLUSION:We found that about 79% of injections were placed intraarticularly, which was comparable with the findings of previous studies using image guidance, and provided meaningful improvements in pain and function for 6 weeks. These findings suggest that for experienced fellowship-trained hand surgeons, non-image-guided injections remain a viable option. Future studies should explore long-term outcomes and the potential role of adjunctive treatments such as antiinflammatory medications and splinting to enhance patient care. LEVEL OF EVIDENCE:Level II, therapeutic study.
PMID: 39617750
ISSN: 1528-1132
CID: 5804242
Canagliflozin-induced adaptive metabolism in bone
Sodium-glucose transporter-2 inhibitor (SGLT2i) drugs are widely used for lowering blood glucose levels independent of insulin. Beyond this, these drugs induce various metabolic changes, including weight loss and impaired bone integrity. There is a significant gap in understanding SGLT2i-induced skeletal changes, as SGLT2 is not expressed in osteoblasts or osteocytes, which use glucose to remodel the bone matrix. We studied the impact of 1, 3, or 6 months of canagliflozin (CANA), an SGLT2i treatment, on the skeleton of 6-month-old genetically heterogeneous UM-HET3 mice. Significant metabolic adaptations to CANA were evident as early as 1.5 months post-treatment, specifically in male mice. CANA-treated male mice exhibited notable reductions in body weight and decreased proinflammatory and bone remodeling markers associated with reduced cortical bone remodeling indices. Bone tissue metabolome indicated enrichment in metabolites related to amino acid transport and tryptophan catabolism in CANA-treated male mice. In contrast, CANA-treated female mice showed increases in nucleic acid metabolism. An integrOmics approach of source-matched bone tissue metabolome and bone marrow RNAseq indicated a positive correlation between the two omics data sets in male mice. Three clusters of transcripts and metabolites involved in energy metabolism, oxidative stress response, and cellular proliferation and differentiation were reduced in CANA-treated male mice. In conclusion, CANA affects bone metabolism mainly via the 'glucose restriction state' it induces and impacts bone cell proliferation and differentiation. These findings underline the effects of SGLT2i on bone health and highlight the need to consider sex-specific responses when developing clinical treatments that alter substrate availability.
PMID: 39932694
ISSN: 1939-327x
CID: 5793332
Application of 3D Printing in Cleft Lip and Palate Repair
This manuscript reviews the transformative impact of 3-dimensional (3D) printing technologies in the treatment and management of cleft lip and palate (CLP), highlighting its application across presurgical planning, surgical training, implantable scaffolds, and postoperative care. By integrating patient-specific data through computer-aided design and manufacturing, 3D printing offers tailored solutions that improve surgical outcomes, reduce operation times, and enhance patient care. The review synthesizes current research findings, technical advancements, and clinical applications, illustrating the potential of 3D printing to revolutionize CLP treatment. Further, it discusses the future directions of combining 3D printing with other innovative technologies like artificial intelligence, 4D printing, and in situ bioprinting for more comprehensive care strategies. This paper underscores the necessity for multidisciplinary collaboration and further research to overcome existing challenges and fully utilize the capabilities of 3D printing in CLP repair.
PMID: 38738906
ISSN: 1536-3732
CID: 5664282
Vascularized Composite Allotransplantation of the Uterus: A Systematic Review of Eligibility Criteria
BACKGROUND:Uterus transplantation (UTx) is the sole clinical treatment for patients with a diagnosis of uterine infertility factor to experience gestation and delivery. Following UTx, candidates who have been largely healthy must agree to extensively interface with the healthcare system and practice strict adherence to an immunosuppressive regimen to protect the allograft until delivery of a live birth. Aside from the risks associated with immunosuppression, UTx recipients often face complicated pregnancies, with a possibility of pregnancy loss and allograft failure. Therefore, appropriate recipient eligibility criteria are central to transplantation success. The objective of this study is to investigate eligibility criteria reported by UTx programs globally. METHODS:A systematic review of UTx literature was conducted according to Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, using PubMed, Cochrane, Ovid/MEDLINE, and Scopus. ClinicalTrials.gov entries and program websites were queried for eligibility criteria as well. RESULTS:Two hundred ninety-six studies were identified, 79 of which were included in the final review. Twenty-one clinical trials and 6 patient-facing websites were included. Most reported eligibility criteria included females of reproductive age, excellent in vitro fertilization candidacy, psychological stability, absence of systemic infection, and willingness to comply with all treatment protocols. The importance of factors such as social support and recipient relationship with their partner varied between centers. CONCLUSION/CONCLUSIONS:Although consensus exists across certain eligibility criteria, the importance of other criteria presents greater ambiguity across centers. As UTx programs expand, and more patients gain access to the procedure, the evolution of eligibility criteria must be documented to optimize best practices across centers.
PMID: 40272522
ISSN: 1536-3708
CID: 5830522
