A Systematic Quality Assessment of Online Resources on Eyelid Ptosis Using the Modified Ensuring Quality Information for Patients (mEQIP) Tool.

BACKGROUND: Eyelid ptosis is an underestimated pathology deeply affecting patients' quality of life. Internet has increasingly become the major source of information regarding health care, and patients often browse on websites to acquire an initial knowledge on the subject. However, there is lack of data concerning the quality of available information focusing on the eyelid ptosis and its treatment. We systematically evaluated online information quality on eyelid ptosis by using the "Ensuring Quality Information for Patients" (EQIP) scale. MATERIALS AND METHODS: Google, Yahoo and Bing have been searched for the keywords "Eyelid ptosis," "Eyelid ptosis surgery" and "Blepharoptosis." The first 50 hits were included, evaluating the quality of information with the expanded EQIP tool. Websites in English and intended for general non-medical public use were included. Irrelevant documents, videos, pictures, blogs and articles with no access were excluded. RESULTS: Out of 138 eligible websites, 79 (57,7%) addressed more than 20 EQIP items, with an overall median score of 20,2. Only 2% discussed procedure complication rates. The majority fail to disclose severe complications and quantifying risks, fewer than 18% clarified the potential need for additional treatments. Surgical procedure details were lacking, and there was insufficient information about pre-/postoperative precautions for patients. Currently, online quality information has not improved since COVID-19 pandemic. CONCLUSIONS: This study highlights the urgent requirement for improved patient-oriented websites adhering to international standards for plastic and oculoplastic surgery. Healthcare providers should effectively guide their patients in finding trustworthy and reliable eyelid ptosis correction information. 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 www.springer.com/00266 .

HMGA1 and MMP-11 Are Overexpressed in Human Non-melanoma Skin Cancer.

BACKGROUND/AIM: The High-Mobility Group A1 (HMGA1) protein has been implicated in human malignancies, playing an important role in cancer proliferation, angiogenesis and metastasis. Increased HMGA1 expression has been found in skin mouse tumors, whereas Hmga1-null mice were protected against skin carcinogenesis. Here, we examined the expression of HMGA1 in human skin tumors, squamous cell carcinoma and basal cell carcinoma. MATERIALS AND METHODS: Tumor and normal skin tissues from 15 affected patients were surgically excised, and mRNA and protein extraction was performed. mRNA and protein content for both HMGA1 and MMP-11, a proteinase enzyme that plays a role in tumor development and progression, was measured by real-time PCR and western blotting, respectively. Data were analyzed by the SPSS software. RESULTS: HMGA1 mRNA and protein expression patterns were higher in neoplastic skin lesions, compared to normal skin (p<0.001). Similar results were observed for MMP-11. CONCLUSION: Our data confirm previous observations in mice studies, and suggest that HMGA1 and MMP-11 may play a key role in the proliferation and progression of skin tumors in humans.

Surgical strategies for cutaneous neoplasm of the scalp. State of art.

AIM: Scalp reconstruction has always been a challenging task, in particular after oncological demolition and this article gives an overview on the state of the art in scalp reconstruction strategies. MATERIAL OF STUDY: We elaborated a systematic algorithm for scalp reconstruction based on location and size defects, presence or absence of periosteum, bone involvement, the quality of surrounding scalp tissue, the presence or absence of hair, location of the hairline, patient comorbidities and different procedures commonly used in plastic surgery. RESULTS: Our algorithm allows plastic surgeons to perform scalp reconstruction after the most devastating of defects. DISCUSSION: Successful reconstruction of the scalp requires careful preoperative planning and detailed knowledge of scalp anatomy, hair physiology, variety of available local tissue and plastic surgery procedures as well as synthetic substitutes or products provided by tissue engineering. CONCLUSION: However, the challenge today is to do so with excellent cosmetic results.

Abdominal desmoid tumors. A new reconstructive approach.

INTRODUCTION: Desmoid tumors are rare soft tissue tumors derived from musculoaponeurotic structures of the abdominal wall musculature. Although they are considered benign tumors because they don't metastasize to other parts of the body, they are clinically considered as malignant for their high tendency on infiltrative growth with local invasion and trend to recurrence after local excision. Several reconstructive techniques are proposed in the literature. METHODS: Nine female patients with abdominal desmoid tumors underwent the removal of a mass of tissue running from the skin to peritoneum near the tumor with a safety margin in macroscopically normal tissue at least of 5 centimeters from the edge of the tumor. After wide excision, a polypropylene mesh was placed in the rear muscular pocket without anchoring suture (sliding mesh sutureless hernioplasty) RESULTS: No patients had perioperative complications or abdominal wall weakness or an incisional hernia in the following 5 years. CONCLUSIONS: We consider this technique of abdominal wall reconstruction after desmoid tumor removal a simple procedure that reduces relapsing events and recurrences of abdominal hernia, reducing tension and pain caused by the traditional suture repair technique. LEVEL OF EVIDENCE: IV.

The primacy of the Vianeo family in the invention of nasal reconstruction technique.

The birth of plastic surgery is identified with the history of rhinoplasty, which was practiced in ancient India when nose amputations were a common practice. Nose reconstruction was the most frequent surgical operation required in India at that time, and it was based on the use of a forehead flap and called an Indian method. The revolution of this technique took place in the south of Italy in the 15th century with the introduction of "the Italian method" invented by 2 families: the Brancas from Sicily and the Vianeos from Calabria. In our opinion, many questions remain as to why the Branca and Vianeo families began nose reconstruction; how and from whom they learned this technique; and which of the 2 families was first to practice it. Gustavo Branca has been always considered as the inventor of the Italian method. Historical references date Brancas in the first half of 15th century and Vianeos in the second half of the same century, but the dates can be inverted. Vianeos are no more the successor, but they are contemporary or immediately predecessors because by our documentation Vincenzo Vianeo, first surgeon of his family, performed rhinoplasty operation in the early years of the 15th century.