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Artikel: The SIEA SHRIMP Flap: An Ultrathin Axial Pattern Free Flap Useable in Obese Patients.

Felder, John M / Willborg, Brooke E / Zhu, William Y

Plastic and reconstructive surgery. Global open

2022 Band 10, Heft 4, Seite(n) e4274

Abstract: The reconstruction of distal extremity wounds poses a unique surgical challenge. In free tissue transfer, a thin, pliable skin flap is the ideal. Obese patients have a paucity of thin skin donor sites. Herein we report the discovery of a free SHRIMP flap ...

Abstract	The reconstruction of distal extremity wounds poses a unique surgical challenge. In free tissue transfer, a thin, pliable skin flap is the ideal. Obese patients have a paucity of thin skin donor sites. Herein we report the discovery of a free SHRIMP flap (Superthin Harvest of a Reliable Islanded Medial Pannus flap) based on the SIEA vessels, harvested from a thick abdominal pannus at the time of cosmetic abdominoplasty. A 61-year-old woman with a chronic wound of the right Achilles tendon was evaluated for reconstruction after failing conservative measures. At the time of consultation, the patient expressed interest in abdominoplasty. Therefore, a skin flap from the abdomen or rectus abdominis muscle flap in the context of an abdominoplasty was offered. Despite obesity affecting the pannus, the superficial inferior epigastric vessels were found to course superficially beneath the dermis at time of abdominoplasty. This allowed straightforward harvest of a superthin flap of skin and minimal subcutaneous fat, which contoured to the ankle with an aesthetically pleasing outcome. The patient was satisfied with the results of her abdominoplasty and coverage of her chronic wound. The SHRIMP flap provides a straightforward, axial pattern, superthin free skin flap based on the superficial inferior epigastric vessels, and represents a useful option in obese patients. The flap can be combined with abdominoplasty for an aesthetic donor site.
Sprache	Englisch
Erscheinungsdatum	2022-04-22
Erscheinungsland	United States
Dokumenttyp	Case Reports
ZDB-ID	2851682-5
ISSN	2169-7574 ; 2169-7574
ISSN (online)	2169-7574
ISSN	2169-7574
DOI	10.1097/GOX.0000000000004274
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Newborn With Vaginal Cyst.

Willborg, Brooke E / Carroll, Vanessa G / Meltzer, Julie

Global pediatric health

2021 Band 8, Seite(n) 2333794X211052904

Abstract: A full-term newborn female was born with a 0.5 × 0.5 cm golden-colored fluid filled sac at the posterior aspect of the vaginal introitus. Physical examination revealed a patent introitus without additional cysts, a normal positioned urethral meatus, and ... ...

Abstract	A full-term newborn female was born with a 0.5 × 0.5 cm golden-colored fluid filled sac at the posterior aspect of the vaginal introitus. Physical examination revealed a patent introitus without additional cysts, a normal positioned urethral meatus, and a patent anus. Stool and voiding occurred in the first 24 hours of life. Hymenal cysts are rare and spontaneously resolve in the first few weeks of life without intervention. Physical examination is important to distinguish hymenal cysts from other interlabial cysts that may require treatment.
Sprache	Englisch
Erscheinungsdatum	2021-10-21
Erscheinungsland	United States
Dokumenttyp	Case Reports
ZDB-ID	2785531-4
ISSN	2333-794X ; 2333-794X
ISSN (online)	2333-794X
ISSN	2333-794X
DOI	10.1177/2333794X211052904
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Management of Traumatic Soft Tissue Injuries of the Face.

Cho, Daniel Y / Willborg, Brooke E / Lu, G Nina

Seminars in plastic surgery

2021 Band 35, Heft 4, Seite(n) 229–237

Abstract: Facial soft tissue injuries encompass a broad spectrum of presentations and often present significant challenges to the craniofacial surgeon. A thorough and systematic approach to these patients is critical to ensure that the patient is stabilized, other ...

Abstract	Facial soft tissue injuries encompass a broad spectrum of presentations and often present significant challenges to the craniofacial surgeon. A thorough and systematic approach to these patients is critical to ensure that the patient is stabilized, other injuries identified, and the full extent of the injuries are assessed. Initial management focuses on wound cleaning with irrigation, hemostasis, and debridement of nonviable tissue. Definitive management is dependent on the region of the face involved with special considerations for critical structures such as the globe, lacrimal apparatus, facial nerve, and parotid duct. Following sound surgical principles, these injuries can be managed to maximize both functional and aesthetic outcomes while minimizing complications.
Sprache	Englisch
Erscheinungsdatum	2021-09-23
Erscheinungsland	United States
Dokumenttyp	Journal Article ; Review
ZDB-ID	2077828-4
ISSN	1535-2188
ISSN	1535-2188
DOI	10.1055/s-0041-1735814
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Management of Traumatic Soft Tissue Injuries of the Face

Cho, Daniel Y. / Willborg, Brooke E. / Lu, G. Nina

Seminars in Plastic Surgery

(The Harborview Approach to Craniofacial Trauma)

2021 Band 35, Heft 04, Seite(n) 229–237

Serientitel	The Harborview Approach to Craniofacial Trauma
Abstract	Facial soft tissue injuries encompass a broad spectrum of presentations and often present significant challenges to the craniofacial surgeon. A thorough and systematic approach to these patients is critical to ensure that the patient is stabilized, other injuries identified, and the full extent of the injuries are assessed. Initial management focuses on wound cleaning with irrigation, hemostasis, and debridement of nonviable tissue. Definitive management is dependent on the region of the face involved with special considerations for critical structures such as the globe, lacrimal apparatus, facial nerve, and parotid duct. Following sound surgical principles, these injuries can be managed to maximize both functional and aesthetic outcomes while minimizing complications.
Schlagwörter	facial trauma ; soft tissue injury ; laceration ; facial nerve ; parotid duct
Sprache	Englisch
Erscheinungsdatum	2021-09-23
Verlag	Thieme Medical Publishers, Inc.
Erscheinungsort	Stuttgart ; New York
Dokumenttyp	Artikel
ZDB-ID	2077828-4
ISSN	1536-0067 ; 1535-2188
ISSN (online)	1536-0067
ISSN	1535-2188
DOI	10.1055/s-0041-1735814
Datenquelle	Thieme Verlag

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Artikel ; Online: Is there a role for fetal interventions in gastroschisis management? - An updated comprehensive review.

Willborg, Brooke E / Ibirogba, Eniola R / Trad, Ayssa Teles Abrao / Sbragia, Lourenço / Potter, Dean / Ruano, Rodrigo

Prenatal diagnosis

2020 Band 41, Heft 1, Seite(n) 159–176

Abstract: We conducted a comprehensive evidence-based review on the epidemiology and current standard of care of gastroschisis management as well as the pathophysiology, rationale and feasibility of fetal therapy as a viable alternative. Gastroschisis is a ... ...

Abstract	We conducted a comprehensive evidence-based review on the epidemiology and current standard of care of gastroschisis management as well as the pathophysiology, rationale and feasibility of fetal therapy as a viable alternative. Gastroschisis is a periumbilical abdominal wall defect characterized by abdominal viscera herniation in utero. It affects 4 in 10 000 live births, but the prevalence has steadily increased in recent years. Gastroschisis is typically diagnosed on routine second-trimester ultrasound. The overall prognosis is favorable, but complex gastroschisis, which accounts for about 10% to 15% of cases, is associated with a higher mortality, significant disease burden and higher healthcare costs due to long- and short-term complications. The current standard of care has yet to be established but generally involves continued fetal surveillance and multidisciplinary perinatal care. Postnatal surgical repair is achieved with primary closure, staged silo closure or sutureless repair. Experimental animal studies have demonstrated the feasibility of in utero closure, antiinflammatory therapy and prenatal regenerative therapy. However, reports of early preterm delivery and amnioinfusion trials have failed to show any benefit in humans. Further experimental studies and human trials are necessary to demonstrate the potential benefit of fetal therapy in gastroschisis.
Mesh-Begriff(e)	Animals ; Fetal Therapies ; Gastroschisis/surgery ; Humans
Sprache	Englisch
Erscheinungsdatum	2020-11-01
Erscheinungsland	England
Dokumenttyp	Journal Article ; Review
ZDB-ID	82031-3
ISSN	1097-0223 ; 0197-3851
ISSN (online)	1097-0223
ISSN	0197-3851
DOI	10.1002/pd.5820
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Verification of prognostic expression biomarkers is improved by examining enriched leukemic blasts rather than mononuclear cells from acute myeloid leukemia patients.

Pogosova-Agadjanyan, Era L / Hua, Xing / Othus, Megan / Appelbaum, Frederick R / Chauncey, Thomas R / Erba, Harry P / Fitzgibbon, Matthew P / Jenkins, Isaac C / Fang, Min / Lee, Stanley C / Moseley, Anna / Naru, Jasmine / Radich, Jerald P / Smith, Jenny L / Willborg, Brooke E / Willman, Cheryl L / Wu, Feinan / Meshinchi, Soheil / Stirewalt, Derek L

Biomarker research

2023 Band 11, Heft 1, Seite(n) 31

Abstract: Background: Studies have not systematically compared the ability to verify performance of prognostic transcripts in paired bulk mononuclear cells versus viable CD34-expressing leukemic blasts from patients with acute myeloid leukemia. We hypothesized ... ...

Abstract	Background: Studies have not systematically compared the ability to verify performance of prognostic transcripts in paired bulk mononuclear cells versus viable CD34-expressing leukemic blasts from patients with acute myeloid leukemia. We hypothesized that examining the homogenous leukemic blasts will yield different biological information and may improve prognostic performance of expression biomarkers. Methods: To assess the impact of cellular heterogeneity on expression biomarkers in acute myeloid leukemia, we systematically examined paired mononuclear cells and viable CD34-expressing leukemic blasts from SWOG diagnostic specimens. After enrichment, patients were assigned into discovery and validation cohorts based on availability of extracted RNA. Analyses of RNA sequencing data examined how enrichment impacted differentially expressed genes associated with pre-analytic variables, patient characteristics, and clinical outcomes. Results: Blast enrichment yielded significantly different expression profiles and biological pathways associated with clinical characteristics (e.g., cytogenetics). Although numerous differentially expressed genes were associated with clinical outcomes, most lost their prognostic significance in the mononuclear cells and blasts after adjusting for age and ELN risk, with only 11 genes remaining significant for overall survival in both cell populations (CEP70, COMMD7, DNMT3B, ECE1, LNX2, NEGR1, PIK3C2B, SEMA4D, SMAD2, TAF8, ZNF444). To examine the impact of enrichment on biomarker verification, these 11 candidate biomarkers were examined by quantitative RT/PCR in the validation cohort. After adjusting for ELN risk and age, expression of 4 genes (CEP70, DNMT3B, ECE1, and PIK3CB) remained significantly associated with overall survival in the blasts, while none met statistical significance in mononuclear cells. Conclusions: This study provides insights into biological information gained/lost by examining viable CD34-expressing leukemic blasts versus mononuclear cells from the same patient and shows an improved verification rate for expression biomarkers in blasts.
Sprache	Englisch
Erscheinungsdatum	2023-03-16
Erscheinungsland	England
Dokumenttyp	Journal Article
ZDB-ID	2699926-2
ISSN	2050-7771
ISSN	2050-7771
DOI	10.1186/s40364-023-00461-0
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Surgical Science-Simbionix Robotic Hysterectomy Simulator: Validating a New Tool.

Cope, Adela G / Lazaro-Weiss, Jose J / Willborg, Brooke E / Lindstrom, Elizabeth D / Mara, Kristin C / Destephano, Christopher C / Vetter, Monica Hagan / Glaser, Gretchen E / Langstraat, Carrie L / Chen, Anita H / Martino, Martin A / Dinh, Tri A / Salani, Ritu / Green, Isabel C

Journal of minimally invasive gynecology

2022 Band 29, Heft 6, Seite(n) 759–766

Abstract: Study objective: To gather validity evidence for and determine acceptability of Surgical Science-Simbionix Hysterectomy Modules for the DaVinci Xi console simulation system (software; 3D Systems by Simbionix [now Surgical Science-Simbionix], Littleton, ... ...

Abstract	Study objective: To gather validity evidence for and determine acceptability of Surgical Science-Simbionix Hysterectomy Modules for the DaVinci Xi console simulation system (software; 3D Systems by Simbionix [now Surgical Science-Simbionix], Littleton, CO, and hardware; Intuitive Surgical, Inc., Sunnyvale, CA) and evaluate performance benchmarks between novice and experienced or expert surgeons. Design: Prospective education study (Messick validity framework). Setting: Multicenter, academic medical institutions. Participants: Residents, fellows, and faculty in obstetrics and gynecology were invited to participate at 3 institutions. Participants were categorized by experience level: fewer than 10 hysterectomies (novice), 10 to 50 hysterectomies (experienced), and more than 50 hysterectomies (expert). A total of 10 novice, 10 experienced, and 14 expert surgeons were included. Interventions: Participants completed 4 simulator modules (ureter identification, bladder flap development, colpotomy, complete hysterectomy) and a qualitative survey. Simulator recordings were reviewed in duplicate by educators in minimally invasive gynecologic surgery using the Modified Global Evaluative Assessment of Robotic Skills (GEARS) rating scale. Measurements and main results: Most participants felt that the simulator realistically simulated robotic hysterectomy (64.7%) and that feedback provided by the simulator was as or more helpful than feedback from previous simulators (88.2%) but less helpful than feedback provided in the operating room (73.5%). Participants felt that this simulator would be helpful for teaching junior residents. Simulator-generated metrics correlated with GEARS performance for the bladder flap and ureter identification modules in multiple domains including total movements and total time for completion. GEARS performance for the bladder flap module correlated with experience level (novice vs experienced/expert) in the domains of interest and total score but did not consistently correlate for the other procedural modules. Performance benchmarks were evaluated for the bladder flap module for each GEARS domain and total score. Conclusion: The modules were well received by participants of all experience levels. Individual simulation modules appear to better discriminate between novice and experienced/expert users than overall simulator performance. Based on these data and participant feedback, the use of individual modules in early residency education may be helpful for providing feedback and may ultimately serve as 1 component of determining readiness to perform robotic hysterectomy.
Mesh-Begriff(e)	Clinical Competence ; Computer Simulation ; Female ; Humans ; Hysterectomy ; Prospective Studies ; Robotic Surgical Procedures/education ; Robotics
Sprache	Englisch
Erscheinungsdatum	2022-02-03
Erscheinungsland	United States
Dokumenttyp	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2186934-0
ISSN	1553-4669 ; 1553-4650
ISSN (online)	1553-4669
ISSN	1553-4650
DOI	10.1016/j.jmig.2022.01.016
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: AML risk stratification models utilizing ELN-2017 guidelines and additional prognostic factors: a SWOG report.

Biomarker research

2020 Band 8, Seite(n) 29

Abstract: Background: The recently updated European LeukemiaNet risk stratification guidelines combine cytogenetic abnormalities and genetic mutations to provide the means to triage patients with acute myeloid leukemia for optimal therapies. Despite the ... ...

Abstract	Background: The recently updated European LeukemiaNet risk stratification guidelines combine cytogenetic abnormalities and genetic mutations to provide the means to triage patients with acute myeloid leukemia for optimal therapies. Despite the identification of many prognostic factors, relatively few have made their way into clinical practice. Methods: In order to assess and improve the performance of the European LeukemiaNet guidelines, we developed novel prognostic models using the biomarkers from the guidelines, age, performance status and select transcript biomarkers. The models were developed separately for mononuclear cells and viable leukemic blasts from previously untreated acute myeloid leukemia patients (discovery cohort, Results: Models using European LeukemiaNet guidelines were significantly associated with clinical outcomes and, therefore, utilized as a baseline for comparisons. Models incorporating age and expression of select transcripts with biomarkers from European LeukemiaNet guidelines demonstrated higher area under the curve and C-statistics but did not show a substantial improvement in performance in the validation cohort. Subset analyses demonstrated that models using only the European LeukemiaNet guidelines were a better fit for younger patients (age < 55) than for older patients. Models integrating age and European LeukemiaNet guidelines visually showed more separation between risk groups in older patients. Models excluding results for Conclusions: While European LeukemiaNet guidelines remain a critical tool for triaging patients with acute myeloid leukemia, the findings illustrate the need for additional prognostic factors, including age, to improve risk stratification.
Sprache	Englisch
Erscheinungsdatum	2020-08-12
Erscheinungsland	England
Dokumenttyp	Journal Article
ZDB-ID	2699926-2
ISSN	2050-7771
ISSN	2050-7771
DOI	10.1186/s40364-020-00208-1
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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