| 1 | Titanium-coated polypropylene mesh as innovative bioactive material in conservatives mastectomies and pre-pectoral breast reconstruction显示文摘Breast reconstruction is rapidly evolving,thanks to the growing acceptance of synthetic meshes as innovative biomaterials.276 patients undergoing mastectomy(total of 328 mastectomies)were analyzed in a retrospective observational study to evaluate the pre-pectoral immediate breast reconstruction(IBR)using an implant wrapped with Titanium-Coated Polypropylene Mesh(TCPM)vs.patients treated with tissue expander(TE),equally placed pre-pectorally(and wrapped with the same TCPM in 74.3%of the control group’breasts).163 patients,of the study group(SG),underwent mastectomy and pre-pectoral IBR with implant wrapped with TCPM,in a one-step surgery,called direct-to-implant technique(DTI),while 113 patients control group(CG)underwent mastectomy and TE.DTI technique has been performed in 192 breasts of the SG while TE procedure in 136 breasts of the CG.The BREAST-Q questionnaire has been provided before the treatment and 2 years later.Baker scale has been used to evaluate capsular contracture.Oncologic,surgical,and aesthetic outcomes along with BREAST-Q scores were analyzed.Additionally,a histologic evaluation was conducted in 11 capsules’samples randomly chosen(6 derived from SG patients and 5 derived from CG).Complications were recorded in 43 cases(29SG-14CG):8 skin-nipple necrosis(5SG-3CG),8 wound dehiscence(6SG-2CG),3 hematomas(1SG-2CG),and 24 infections(8SG-16CG).Grade IV capsular contracture was detected in 9 breasts(1SG-8CG),whereas 254 breasts were grade I(110SG-144CG),33(10SG-23CG)grade II,and 32(4SG-28CG)grade III.Implant wrinkling was detected in 18 cases(10SG-8CG)after 30 months.The local tumor recurrence rate was 5.8%.Three recurrences were on the nipple-areola complex(1.9%).SG patients showed significantly higher rates in the BREAST-Q overall Satisfaction with Outcome(74.1),overall Satisfaction with Breasts(69.1),Psychosocial Well-being(81.9),and Sexual Well-being(63.1),versus CG’s patients(p<0.05).Histological analysis showed a process of normal tissue repair with a complete mesh integration and normal healing.Conservative mastectomies with pre-pectoral IBR assisted by TCPM proved themselves oncologically safe,biologically integrated into native tissues,and highly accepted in terms of quality of life guaranteeing a more natural and aesthetic breast appearance.Core tip:This retrospective observational study provided clinical and histological outcomes of the pre-pectoral IBR using an implant wrapped with TCPM vs.patients treated with TE,equally placed pre-pectorally.The efficacy of IBR using an implant wrapped with TCPM was confirmed by the cosmetic results obtained and by a rate of side effects comparable to TE.All the histological analyses performed confirmed the TCPM mesh complete integration with the physiological aspects of healing:The Collagen 1 and 3 expressions did not differ,between TCPM and NO TCPM samples to confirm a process of healing overlapping to perfect device incorporation and normal healing. | Pietro Gentile Marco Bernini Lorenzo Orzalesi Silvia Sordi Icro Meattini Francesca Lessi Ashutosh Kothari Claudio Calabrese | 2021 | Bioactive Materials2021，6，12： | 2 |
| 3 | Medical Students’Views on Psychiatry in Germany and Italy:Survey显示文摘Objectives:In 2019,the Insititue for Health Metrics and Evaluation reported that 16%of life lost were attributed to mental health.As a result,global shortage of psychiatrists is a pressing issue due to the increasing burden of mental illness.In 2016,a mere 5%of US medical students chose psychiatry as a career,a trend mirrored in Germany and Italy.As the medical students of 2016 have graduated or transitioned into residency in 2023,their attitudes towards psychiatry could have contributed to today’s shortage of psychiatrists.The global mental health burden has only been exacerbated by the COVID-19 pandemic.This study explores the attitudes of German and Italian medical students towards psychiatry,their career aspirations,and the influence of factors such as personal experience and education on their interest in the field.Methods:A cross-sectional survey was conducted among 799 medical students in two European countries in 2016.Participants answered questions about their attitudes towards psychiatry,their psychiatric education,and personal experiences.Inferential analyses were performed using chi-square tests and a significance level of 0.05.Results:The number of years in medical school,personal experiences,and perceived quality of education significantly affected specialty choice and ranking of psychiatry compared to other specialties.Internships,psychiatric placements,and views on psychiatric instructors also played a significant role in choosing psychiatry as a career.Conclusions:Assessing medical students’attitudes towards psychiatry and the factors that influence their career choices,such as psychiatric education and personal experiences,can inform changes to attract students to the field.Addressing the worldwide shortage of psychiatrists is crucial to reduce the burden of mental health and substance use disorders. | Andy Man Yeung Tai Janet Suen Mostafa Mamdouh Kamel Georg Schomerus Angelo Giovanni Icro Maremmaniz Reinhard Michael Krausz | 2023 | International Journal of Mental Health Promotion2023，25，9： | 0 |
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