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Article ; Online: Disparities in Breast Reconstruction: An Analysis of Treatment Choices.

Eregha, Nicole / Villalvazo, Yadira / De La Cruz, Carolyn

2024 Volume 92, Issue 4S Suppl 2, Page(s) S223–S227

Abstract: Background: Breast reconstruction methods vary based on factors such as medical history, breast size, and personal preferences. However, disparities in healthcare exist, and the role race plays in accessing to different reconstruction methods is unclear. ...

Abstract	Background: Breast reconstruction methods vary based on factors such as medical history, breast size, and personal preferences. However, disparities in healthcare exist, and the role race plays in accessing to different reconstruction methods is unclear. This study aimed to investigate the influence of race and/or ethnicity on the type of breast reconstruction chosen. Methods: This retrospective cohort study analyzed the University of Pittsburgh Medical Center Magee Women's Hospital database, including patients who underwent breast cancer surgery from 2011 to 2022. Multivariate analysis examined race, reconstruction, and reconstruction type (P < 0.05). Results: The database included 13,260 women with breast cancer; of whom 1763 underwent breast reconstruction. We found that 91.8% of patients were White, 6.8% Black, and 1.24% were of other races (Asian, Chinese, Filipino, Vietnamese, unknown). Reconstruction types were 46.8% implant, 30.1% autologous, and 18.7% combined. Among Black patients, autologous 36.3%, implant 32.2%, and combined 26.4%. In White patients, autologous 29.5%, implant 48%, and combined 18.2%. Among other races, autologous 36.3%, implant 40.9%, and combined 22.7%. In patients who underwent breast reconstruction, 85.2% underwent unilateral and 14.7% of patients underwent bilateral. Among the patients who had bilateral reconstruction, 92.3% were White, 6.1% were Black, and 1.5% were of other ethnicities. Conclusions: Our analysis revealed differences in breast reconstruction methods. Autologous reconstruction was more common among Black patients, and implant-based reconstruction was more common among Whites and other races. Further research is needed to understand the cause of these variations.
MeSH term(s)	Female ; Humans ; Retrospective Studies ; Mammaplasty/methods ; Mastectomy/methods ; Breast Neoplasms/surgery ; Breast Implants ; Healthcare Disparities
Language	English
Publishing date	2024-04-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	423835-7
ISSN	1536-3708 ; 0148-7043
ISSN (online)	1536-3708
ISSN	0148-7043
DOI	10.1097/SAP.0000000000003862
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Article: Proposal of a Context-sensitive ECG Collection Mobile Health System for Ambulatory Cardiovascular Diseases.

Moreno-De La Cruz, Cristian / Vargas-Lombardo, Miguel

Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH

2023 Volume 31, Issue 1, Page(s) 26–30

Abstract: Background: This study brings innovation oriented to the development of e-health services to improve the performance of healthcare and hospital care in free-living activities.: Objective: This article seeks to propose an innovative mobile software ... ...

Abstract	Background: This study brings innovation oriented to the development of e-health services to improve the performance of healthcare and hospital care in free-living activities. Objective: This article seeks to propose an innovative mobile software that enables the contextualization of clinical data, while integrating the fundamental functionalities and usability criteria of a mobile health (mhealth) system. Methods: We examine the utility of a context-sensitive mobile electrocardiogram (ECG) collection system for the detection of cardiovascular diseases for patients in free-living conditions. Results: We propose an mhealth system that reinforces conventional healthcare systems in which electronic health records are limited by access and processing of data, limiting clinical-medical decision-making. This study highlights the importance of mobile applications for self-care and their usefulness for both patients and healthcare providers. The proposal offers an avenue for the study of contextualized ECG collection methods that can be used to create context-specific actions that reduce false alarms in computer-aided diagnosis of ambulatory ECG. Conclusion: Mobile applications for health care and monitoring improve the quality of life of people with cardiovascular diseases.
Language	English
Publishing date	2023-04-05
Publishing country	Bosnia and Herzegovina
Document type	Journal Article
ZDB-ID	2558601-4
ISSN	1986-5988 ; 0353-8109
ISSN (online)	1986-5988
ISSN	0353-8109
DOI	10.5455/aim.2023.31.26-30
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Article ; Online: Are We Speaking the Same "Language" Regarding Underrepresented Groups in Plastic Surgery and Increasing Diversity Within Our Field?

Douglas, Nerone K O / Moroni, Elizabeth A / De La Cruz, Carolyn / Egro, Francesco M

Annals of plastic surgery

2024 Volume 92, Issue 4S Suppl 2, Page(s) S218–S222

Abstract: Background: Plastic Surgery is one of the fields that lags behind the rest when it comes to surgeons from backgrounds underrepresented in medicine (URiM). Extensive research has shown that diversity in health care not only fosters inclusivity but also ... ...

Abstract	Background: Plastic Surgery is one of the fields that lags behind the rest when it comes to surgeons from backgrounds underrepresented in medicine (URiM). Extensive research has shown that diversity in health care not only fosters inclusivity but also saves lives. The study aim is to quantify how many integrated plastic surgery residency programs have outlined criteria defining diversity goals and/or groups of people they consider to be URiM. Methods: All American Council for Graduate Medical Education-accredited integrated plastic surgery program Web sites were reviewed for diversity missions/statements and explicit mentions of the racial and ethnic groups. Web sites were deemed "up-to-date" if they were last updated within 6 months before the initial data collection period. The data collection period was from November 20 to 29, 2022. Results: A total of 86 program were reviewed. Only 8 programs (9%) had clear URiM criteria listed on their Web sites, whereas 26 (30%) relied on institution/department-wide criteria, 1 (1%) listed that they were adhering to American Association of Medical Colleges definition of URiM, and 51 programs (60%) had no form of definition for what is considered URiM. When looking at the programs that have some form of criteria for URiM (n = 35 [40%]), all programs (100%) considered African American/Black, Native American/Alaskan Native, Hispanic/Latinx, and Pacific Islander/Native Hawaiian as groups URiM. Assessing the same subset of programs that have a form of criteria listed (n = 35 [40%]), 19 (58%) had listed other groups outside of race/ethnicity considered to be URiM for their program, and 14 (42%) programs did not. Fourteen programs (74%) considered LGBTQIA+ as a URiM group. Conclusion and significance: There still is a great deal of heterogeneity among residency programs when it comes to identifying which medical students are URiM. Numerous plastic surgery organizations have placed diversity and inclusive excellence at the forefront of their agendas; however, it is critical that residency programs also actively align their efforts in an equitable and intentional way. This study serves to encourage residency programs to evaluate their mission toward diversity, equity, and inclusion and to spark discussion toward creating a clearer URiM definition to be consistent among all programs.
MeSH term(s)	Humans ; Surgery, Plastic ; Plastic Surgery Procedures ; Black or African American ; Education, Medical, Graduate ; Ethnicity ; Internship and Residency
Language	English
Publishing date	2024-04-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	423835-7
ISSN	1536-3708 ; 0148-7043
ISSN (online)	1536-3708
ISSN	0148-7043
DOI	10.1097/SAP.0000000000003876
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Article ; Online: Alternative Lymphatic Drainage Pathways in the Trunk Following Oncologic Therapy.

Mehta, Meeti / Sarrami, Shayan / Moroni, Elizabeth / Fishman, Jordan / De La Cruz, Carolyn

Annals of plastic surgery

2024 Volume 92, Issue 4S Suppl 2, Page(s) S258–S261

Abstract: Background: Anatomic and functional descriptions of trunk and breast lymphedema following breast cancer treatment are emerging as indicators of lymphatic dysfunction. Indocyanine green-lymphangiography has been instrumental in characterizing this ... ...

Abstract	Background: Anatomic and functional descriptions of trunk and breast lymphedema following breast cancer treatment are emerging as indicators of lymphatic dysfunction. Indocyanine green-lymphangiography has been instrumental in characterizing this dysfunction in the extremity and can be applied to other regions. Previous work has established a validated Pittsburgh Trunk Lymphedema Staging System to characterize such affected areas. This study aims to identify risk and protective factors for the development of truncal and upper extremity lymphedema using alternative lymphatic drainage, providing implications for medical and surgical treatment. Methods: Patients undergoing revisional breast surgery with suspicion of upper extremity lymphedema between 12/2014 and 3/2020 were offered lymphangiography. The breast and lateral/anterior trunks were visualized and blindly evaluated for axillary and inguinal lymphatic flow. A linear-weighted Cohen's kappa statistic was calculated comparing alternative drainage evaluation. Binomial regression was used to compute relative risks (RRs). Significance was assessed at alpha = 0.05. Results: Eighty-six sides (46 patients) were included. Twelve sides underwent no treatment and were considered controls. Eighty-eight percent of the noncontrols had alternative lymphatic flow to the ipsilateral axillae (64%), ipsilateral groins (57%), contralateral axillae (20.3%), and contralateral groins (9.3%). Cohen's kappa for alternative drainage was 0.631 ± 0.043. Ipsilateral axillary and contralateral inguinal drainage were associated with reduced risk of developing truncal lymphedema [RR 0.78, confidence interval (CI) 0.63-0.97, P = 0.04; RR 0.32, CI 0.13-0.79, P = 0.01, respectively]. Radiation therapy increased risk of truncal and upper extremity lymphedema (RR 3.69, CI 0.96-14.15, P = 0.02; RR 1.92, CI 1.09-3.39, P = 0.03, respectively). Contralateral axillary drainage and axillary lymph node dissection were associated with increased risk of upper extremity lymphedema (RR 4.25, CI 1.09-16.61, P = 0.01; RR 2.83, CI 1.23-6.52, P = 0.01, respectively). Conclusions: Building upon previous work, this study shows risk and protective factors for the development of truncal and upper extremity lymphedema. Most prevalent alternative channels drain to the ipsilateral axilla and groin. Ipsilateral axillary and contralateral inguinal drainage were associated with reduced risk of truncal lymphedema. Patients with radiation, axillary dissection, and contralateral axillary drainage were associated with increased risk of upper extremity lymphedema. These findings have important clinical implications for postoperative manual lymphatic drainage and for determining eligibility for lymphovenous bypass surgery.
MeSH term(s)	Humans ; Female ; Upper Extremity/pathology ; Lymph Node Excision/adverse effects ; Axilla/surgery ; Lymphatic System ; Lymphedema/surgery ; Breast Neoplasms/pathology ; Lymphatic Vessels/diagnostic imaging ; Lymphatic Vessels/surgery ; Lymph Nodes/pathology
Language	English
Publishing date	2024-04-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	423835-7
ISSN	1536-3708 ; 0148-7043
ISSN (online)	1536-3708
ISSN	0148-7043
DOI	10.1097/SAP.0000000000003861
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Article ; Online: Correction of Inverted Nipples with Fat Grafting: A Novel Technique for a Challenging Problem.

Anstadt, Erin / Marallo, Michael / De La Cruz, Carolyn

Plastic and reconstructive surgery

2022 Volume 151, Issue 2, Page(s) 347e–348e

Language	English
Publishing date	2022-11-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	208012-6
ISSN	1529-4242 ; 0032-1052 ; 0096-8501
ISSN (online)	1529-4242
ISSN	0032-1052 ; 0096-8501
DOI	10.1097/PRS.0000000000009872
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Article: Essential oils: a systematic review on revolutionizing health, nutrition, and omics for optimal well-being.

Pezantes-Orellana, Camila / German Bermúdez, Fátima / Matías De la Cruz, Carmen / Montalvo, José Luis / Orellana-Manzano, Andrea

Frontiers in medicine

2024 Volume 11, Page(s) 1337785

Abstract: Purpose: Essential oils from various plants have diverse therapeutic properties and are researched extensively. They have applications in medicine, aromatherapy, microbiology, agriculture, livestock, and the food industry, benefiting the population.: ... ...

Abstract	Purpose: Essential oils from various plants have diverse therapeutic properties and are researched extensively. They have applications in medicine, aromatherapy, microbiology, agriculture, livestock, and the food industry, benefiting the population. Methods: This systematic review followed the PRISMA verification protocol. The study focused on the anti-inflammatory effects, nutraceutical properties, antioxidant and antibacterial activity of essential oils in lemon, orange, cumin, cinnamon, coriander, rosemary, thyme, and parsley. We also looked at their presence in the diet, their effect, their mechanism of action on health, and the most important active compounds. The search was conducted in the PubMed database for the last 12 years of publications, including Results: Essential oils have been shown to have multiple health benefits, primarily due to their antimicrobial and anti-inflammatory effects. The mechanism of action of cinnamon oil alters bacterial membranes, modifies lipid profiles, and inhibits cell division, giving a potential benefit in protection against colitis. On the other hand, a significant improvement was observed in the diastolic pressure of patients with metabolic syndrome when supplementing them with cumin essential oil. The antimicrobial properties of coriander essential oil, especially its application in seafood like tilapia, demonstrate efficacy in improving health and resistance to bacterial infections. Cumin essential oil treats inflammation. Parsley essential oil is an antioxidant. Orange peel oil is antibacterial, antifungal, antiparasitic, and pro-oxidative. Lemon essential oil affects mouse intestinal microbiota. Thyme essential oil protects the colon against damage and DNA methylation. Carnosic acid in rosemary oil can reduce prostate cancer cell viability by modifying the endoplasmic reticulum function. Conclusion and discussion: Essential oils have many therapeutic and antiparasitic properties. They are beneficial to human health in many ways. However, to understand their potential benefits, more research is needed regarding essential oils such as coriander, parsley, rosemary, cumin, and thyme. These research gaps are relevant since they restrict understanding of the possible benefits of these crucial oils for health-related contexts.
Language	English
Publishing date	2024-02-16
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2024.1337785
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Article ; Online: Repigmentation of the Nipple-Areolar Complex Following Free Nipple Grafting.

Humar, Pooja / Bailey, Elizabeth / De La Cruz, Carolyn / Nguyen, Vu / Gimbel, Michael

Plastic and reconstructive surgery

2023

Abstract: Introduction: Free nipple grafting (FNG) is a technique historically used during breast reduction and gender dysphoria top surgery to minimize nipple areolar complex (NAC) hypoperfusion and subsequent loss. One drawback of this approach is NAC ... ...

Abstract	Introduction: Free nipple grafting (FNG) is a technique historically used during breast reduction and gender dysphoria top surgery to minimize nipple areolar complex (NAC) hypoperfusion and subsequent loss. One drawback of this approach is NAC hypopigmentation. This study seeks to quantify long-term pigmentation changes in the NAC following FNG. Methods: A retrospective review of patients who underwent reduction mammoplasty or simple mastectomy with FNG from 2000-2020 at our institution was conducted. Patients were included if they had pre-operative, early, and late post-operative images. Images were analyzed using NIH Image J software for pigmentation changes over time. Results: Of the 151 patients identified, 56 patients (111 breasts) had complete imaging (macromastia n=47; oncologic n=4; gender dysphoria n=5). All patients had NAC hypopigmentation on early imaging, with 25.5% (SD 18.1%) of the NAC affected. On late imaging, 83 NAC (74.7%) experienced repigmentation with only 8.7% (SD 7.3%) of the NAC area remaining hypopigmented. This represents a 67.2% resolution of pigmentation (p<0.001). 10 NAC (9.0%) had progression of hypopigmentation, and 17 NAC (15.3%) had no change. In a subset analysis by race, Caucasian patients had significantly greater area of NAC hypopigmentation on early post-operative imaging (Caucasian, 29.3% (SD 18.8%) vs Black, 18.3% (SD 14.0%), p<0.01). However, resolution of hypopigmentation was similar between both. Conclusion: While partial hypopigmentation of the NAC is nearly universal following FNG, a majority of patients experience repigmentation with low residual hypopigmentation at 1 year. These findings are useful for counseling patients with early pigmentation changes in addition to guiding surgical decisions about breast surgery with FNG.
Language	English
Publishing date	2023-09-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	208012-6
ISSN	1529-4242 ; 0032-1052 ; 0096-8501
ISSN (online)	1529-4242
ISSN	0032-1052 ; 0096-8501
DOI	10.1097/PRS.0000000000011084
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Article: An Analysis of Confidence Levels in Athletic Training Students During the Coronavirus Pandemic.

DE LA Cruz, Celeste / Resnick, Portia B / Roos, Karen G / Nakajima, Mimi

International journal of exercise science

2023 Volume 16, Issue 3, Page(s) 1284–1292

Abstract: Background: The COVID-19 pandemic created a challenge to athletic training students, with many classes converted to online education, and many clinical experiences interrupted. These changes may have negatively affected the confidence level of athletic ... ...

Abstract	Background: The COVID-19 pandemic created a challenge to athletic training students, with many classes converted to online education, and many clinical experiences interrupted. These changes may have negatively affected the confidence level of athletic training students in their athletic training skills. Purpose: To determine if athletic training students' educational experiences during the COVID-19 pandemic have impacted their confidence levels in completing athletic training skills. Procedures: A cross-sectional design using an online survey of 56 athletic training students from 33 CAATE accredited athletic training programs was used. The survey consisted of questions about the percentage of online learning, didactically and clinically, during the pandemic and confidence levels for skills within the five athletic training domains. Descriptive statistics were calculated, and factorial ANOVAs were used to analyze the level of confidence by semester of clinical experience. Main findings: Factorial ANOVA demonstrated lower perceived confidence levels for students who had more online clinical experience for the following domains: injury and illness prevention and wellness promotion, therapeutic intervention, and healthcare administration and professional responsibility. Confidence was also lower in correctly performing the clinical skills for evaluating spine and torso, developing and implementing a rehabilitation program for the lower extremity, and developing and implementing a rehabilitation program for the back. Principal. Conclusion: Athletic training students who had large portion of their clinical and classroom experience online had perceived lower levels of confidence in performing clinical and administrative skills. Online learning may influence athletic training students' confidence level in performing athletic training skills.
Language	English
Publishing date	2023-10-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2411342-6
ISSN	1939-795X
ISSN	1939-795X
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Article ; Online: A Systematic Study on the Redox Potentials of Phenazine-Derivatives in Aqueous Media: A Combined Computational and Experimental Work.

de la Cruz, Carlos / Sanz, Roberto / Suárez, Anisley / Ventosa, Edgar / Marcilla, Rebeca / Mavrandonakis, Andreas

ChemSusChem

2023 Volume 16, Issue 8, Page(s) e202201984

Abstract: Phenazines are an emerging class of organic compounds that have been recently utilized in aqueous redox flow batteries, a promising technology for large-scale energy storage. A virtual screening based on density functional theory calculations is used to ... ...

Abstract	Phenazines are an emerging class of organic compounds that have been recently utilized in aqueous redox flow batteries, a promising technology for large-scale energy storage. A virtual screening based on density functional theory calculations is used to investigate the redox potentials of around 100 phenazine derivatives in aqueous media containing various electron-donating or electron-withdrawing groups at different positions. The calculations identify the crucial positions that should be functionalized with multiple hydroxy groups to design new anolytes. The combined experimental-computational methodology reported herein guides the development of a new molecule with a record low reversible redox potential as a potential anolyte for aqueous redox flow batteries.
Language	English
Publishing date	2023-03-09
Publishing country	Germany
Document type	Journal Article
ISSN	1864-564X
ISSN (online)	1864-564X
DOI	10.1002/cssc.202201984
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Article ; Online: Health-related quality of life in patients with generalized pustular psoriasis: A systematic literature review.

Choon, S E / De La Cruz, C / Wolf, P / Jha, R K / Fischer, K I / Goncalves-Bradley, D C / Hepworth, T / Marshall, S R / Gottlieb, A B

Journal of the European Academy of Dermatology and Venereology : JEADV

2023 Volume 38, Issue 2, Page(s) 265–280

Abstract: Generalized pustular psoriasis (GPP) is a rare, chronic, neutrophilic inflammatory skin disease characterized by episodes of widespread eruption of sterile, macroscopic pustules that can be accompanied by systemic inflammation and symptoms. A systematic ... ...

Abstract	Generalized pustular psoriasis (GPP) is a rare, chronic, neutrophilic inflammatory skin disease characterized by episodes of widespread eruption of sterile, macroscopic pustules that can be accompanied by systemic inflammation and symptoms. A systematic literature review and narrative synthesis were conducted to determine the impact of GPP on patients' health-related quality of life (HRQoL) and patient-reported severity of symptoms and to compare its impact to patients with plaque psoriasis (plaque PsO). Searches were undertaken in Embase, MEDLINE and the Cochrane Library from 1 January 2002 to 15 September 2022. Screening was carried out by two reviewers independently. Outcome measures included generic (e.g. EQ-5D, SF-36) and dermatology-specific (e.g. DLQI) clinical outcome assessments, and other relevant patient-reported outcome measures (PROMs) (e.g. severity of pain measured by a numerical rating scale). Overall, 20 studies were found to be eligible for inclusion, of which seven also had data for plaque PsO. The DLQI was the most frequently reported outcome measure (16 out of 20 studies). When reported, mean DLQI (SD) scores varied from 5.7 (1.2) to 15.8 (9.6) across the studies, indicating a moderate to very large effect on HRQoL; the wide range of scores and large SDs were explained by the small population sizes (n ≤ 12 for all studies except two). Similar ranges and large SDs were also observed for other measures within individual studies. However, in general, people with GPP reported a greater impact of their skin condition on HRQoL, when compared to people with plaque PsO (i.e. higher DLQI scores) and higher severity for itch, pain and fatigue. This systematic review highlighted the need for studies with a larger population size, a better understanding of the impact of cutaneous and extracutaneous symptoms and comorbidities on HRQoL during and between GPP flares, and outcome measures specifically tailored to the unique symptoms and the natural course/history of GPP.
MeSH term(s)	Humans ; Quality of Life ; Psoriasis/diagnosis ; Skin ; Chronic Disease ; Skin Diseases, Vesiculobullous ; Dermatitis ; Pain
Language	English
Publishing date	2023-10-13
Publishing country	England
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	1128828-0
ISSN	1468-3083 ; 0926-9959
ISSN (online)	1468-3083
ISSN	0926-9959
DOI	10.1111/jdv.19530
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