Faculty Bibliography
Searched for:
school:SOM
Department/Unit:Plastic Surgery
Total Results:
5690
Bridging the evidence gap in gender-affirming care: urgent research needs
Gender-affirming care has emerged as a critical component of healthcare, addressing the specific medical and psychosocial needs of transgender and non-binary individuals. In this review article, we address what we see as the most pressing evidence gaps in the gender health literature: long-term effects of pubertal blockers and gender-affirming hormone therapy and the lack of standardised outcome measures of gender-affirming care. Substantial uncertainties persist regarding long-term effects of hormone therapy and the implications of gender-affirming therapy on cancer risk. Though there is some uncertainty about the long-term effects of gender-affirming medical therapy, providers must also consider the potential negative consequences of prolonging a dysphoric experience. Additionally, there is a dearth of validated measures for patient-reported outcomes and a lack of standardisation in the reporting of data that is detrimental to the progress of understanding the impacts of gender-affirming care.
PMID: 40457589
ISSN: 1464-410x
CID: 5862202
Discussion: Mastectomy for Individuals with Gender Dysphoria Younger Than 26 Years: A Systematic Review and Meta-Analysis
PMID: 40434656
ISSN: 1529-4242
CID: 5855362
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
Computer-based Simulation of Facial Flap and Cleft Lip Reconstruction Using Multiresolution Physics
Computer-based simulation of complex local flap reconstructions of the face requires very high-density finite elements to render accurately due to the intricate incision designs frequently used. This is particularly true in detailed cleft lip/nose repairs. If the entire anatomic model is embedded in a high-resolution solid lattice, the element count becomes so high that simulator performance is very slow, even on a high-performance workstation. This article introduces a simulator in which the model is initially presented at a low, but acceptable physical resolution. As the surgeon operates on the model, only the areas impacted are recut at very high resolution. This surgical subvolume is then merged back into the rest of the model. The dramatic reduction in finite element count results in a surgical simulation program that is quite fast, even on a modest personal computer. This article presents examples of this simulator used in a variety of facial flap and cleft lip reconstructions. Future uses in plastic surgery for patient-specific simulation, education, and illustration are discussed. The simulator is available as free, open-source software.
PMCID:12133145
PMID: 40469555
ISSN: 2169-7574
CID: 5862632
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
Response to Andersen et al.'s "A genome-wide association meta-analysis links hidradenitis suppurativa to common and rare sequence variants causing disruption of the Notch and Wnt/β-catenin signaling pathways." [Letter]
PMID: 40334920
ISSN: 1097-6787
CID: 5839282
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
Early Steps of the Kidney Transplant Process: What Are the Experiences of Dialysis Social Workers?
INTRODUCTION/BACKGROUND:Dialysis social workers (DSWs) educate and advocate for end-stage kidney disease (ESKD) patients during the kidney transplantation (KT) process. However, little is known about the barriers DSWs face as they help patients get waitlisted and how to best support their efforts. We interviewed DSWs across New York (NY) State to examine their experiences, supports, and challenges in helping dialysis patients progress through KT education, referral, and evaluation. METHODS:We conducted semi-structured interviews with DSWs in NY State who had participated or expressed interest in a program designed to educate DSWs about KT and used rapid qualitative analysis to identify themes. FINDINGS/RESULTS:We interviewed 17 DSWs. Seven themes emerged: (1) DSWs report involvement in KT interest assessment, education, referral, and evaluation support, (2) DSWs report varying nephrologist support in helping patients progress to KT, (3) DSWs perceive social support and adherence as key factors in KT centers' eligibility determinations, (4) DSWs have knowledge gaps around living donation and appreciate learning about KT from transplant centers and non-profit organizations, (5) Patients express KT concerns and DSWs counsel them about these concerns, (6) DSWs report solutions to help patients complete KT evaluation appointments, and (7) DSWs report communication deficiencies between dialysis centers and transplant centers, and patients. CONCLUSIONS:Education for DSWs, support from nephrologists, and resources to help patients complete KT evaluation steps facilitated DSW engagement throughout the pre-transplant process, underscoring the need for multi-level, cross-disciplinary programs to support these efforts.
PMID: 40391920
ISSN: 1399-0012
CID: 5852962
