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1.
Ann Chir Plast Esthet ; 66(1): 19-24, 2021 Feb.
Artigo em Francês | MEDLINE | ID: mdl-33483169

RESUMO

BACKGROUND: The use of social media, has been a major upheaval in our lifestyles in the last decade. At the forefront in the crisis of BIA-ALCL, as soon as February 2019, our university centre took steps to identify and contact all patients with macro-textured implants. The purpose of this recall was to educate patients and establish a monitoring system. The purpose of this work is to analyse the patients' decision-making process. METHODS: A retrospective study of patients, who requested and attended appointments with a surgeon, was made. The number of patients with clinical symptoms of BIA-ALCL, the number of patients who requested implant removal surgery, the histological diagnoses found after surgery were collected. We then calculated the proportion of Facebook group members among patients who required implant removal in the absence of a diagnosis or even warning signs. RESULTS: Seven hundred and seventy women requested an appointment with one of the surgeons in our department. Of all the women who requested consultation, 497 (64.55%) had symptoms. 199 patients were members or had attended one of the Facebook groups of patients. At the end of the consultation with their surgeon, almost 25% of patients made a decision to have the implant removed against medical advice. Among these patients, 67% were part of a group of patients on the Facebook network. To date, no patient has been diagnosed with BIA-ALCL. CONCLUSIONS: These results support the hypothesis that belonging to Facebook groups of patients becomes, for some, a key element in the decision-making process beyond expert opinion. In the future, preliminary work with patient groups on social networks should be done in order to obtain additional health efficiency.


Assuntos
Implante Mamário , Implantes de Mama , Neoplasias da Mama , Linfoma Anaplásico de Células Grandes , Mídias Sociais , Neoplasias da Mama/cirurgia , Tomada de Decisões , Feminino , Humanos , Linfoma Anaplásico de Células Grandes/cirurgia , Estudos Retrospectivos
2.
Ann Chir Plast Esthet ; 58(3): 188-93, 2013 Jun.
Artigo em Francês | MEDLINE | ID: mdl-23602272

RESUMO

The microsurgical failure rate is almost constant for several decades. We present two case reports describing a novel method of free flap salvage using angioradiological techniques. Our first case shows the potential utility of in situ thrombolysis, our second case describes the first use of stents within a microsurgical anastomosis. In boths cases, the flap would have been lost immediately, because flap revisions failed. Thus, before abandoning on a flap, one could perform a simple angiography to evaluate further angioradiological salvage possibilities and hereby contribute to improve long term microsurgical failure rate.


Assuntos
Angiografia , Retalhos de Tecido Biológico/irrigação sanguínea , Radiografia Intervencionista , Terapia de Salvação/métodos , Anastomose Cirúrgica , Arteriopatias Oclusivas/terapia , Retalhos de Tecido Biológico/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Stents , Terapia Trombolítica , Ativador de Plasminogênio Tecidual/uso terapêutico , Adulto Jovem
3.
Ann Chir Plast Esthet ; 58(3): 201-7, 2013 Jun.
Artigo em Francês | MEDLINE | ID: mdl-23273908

RESUMO

PURPOSE: Scanning electron microscopy (SEM) is a powerful analytical tool that allows the study of interactions between commonly used biomaterials and the human body. In conventional SEM (HiVac), hydrated biological samples cannot be analyzed in their natural state and must be dried and metallized. The primary goal of this study is to present recent developments in SEM, notably Environmental SEM (ESEM). The secondary objective is to define the potential utility of these new technologies in the study of periprosthetic breast capsules. MATERIALS AND METHODS: Our pilot study group prospectively included 10 patients with breast cancer undergoing 2-stage expander to implant reconstruction. Periprosthetic breast capsule specimens were sampled during expander removal. Each sample was analyzed using both HiVac and ESEM modalities. Energy dispersive X-ray (EDX) studies were also conducted in order to assess the chemical composition of the capsular tissue samples. Under each observation mode, comparisons of samples' three-dimensional surface relief, cellular composition and biofilm presence were made. For each image, a score from 1-3 on a Likert scale was attributed by three independent experts in electron microscopy. RESULTS: HiVac mode was found to be superior to ESEM for the assessment of the three main study parameters (surface relief, cellularity, biofilm). The quality of the EDX analysis was equivalent under both SEM modalities. CONCLUSION: HiVac mode was shown to be more appropriate than ESEM for the global analysis of periprosthetic breast capsules. EDX analysis permits the identification of atypical chemical elements in tissue samples.


Assuntos
Implantes de Mama , Mama/patologia , Reação a Corpo Estranho/patologia , Microscopia Eletrônica de Varredura , Biofilmes , Feminino , Humanos , Projetos Piloto , Estudos Prospectivos
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