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research round-up
MEDIUM-TERM COST ANALYSIS OF BREAST RECONSTRUCTIONS IN A SINGLE DUTCH CENTRE: A COMPARISON OF IMPLANTS, IMPLANTS PRECEDED BY TISSUE EXPANSION, LD TRANSPOSITIONS AND DIEP FLAPS
Damen THC, Wei W, Mureau MAM et al. J Plast Reconstr Aesthet Surg 2011; 64(8): 1043–53
F
ree Flap breast reconstruction (br) is generally believed to be more
expensive than implant br, but costs were previously shown to level out over time due to complications and re-operations. the aim of this study was to assess the economic implications of four br techniques: silicone prosthesis (sp), implant preceded by tissue expansion (te/sp),
latissimus dorsi
transposition with or without implant (lD±sp) and deep inferior epigastric perforator (Diep) flap. Methods: a prospective historic cohort study was performed to evaluate intramural medical costs in 427 patients, who had undergone br between 2002 and 2009. short- and medium-term complications were incorporated. in addition, 58 patients, who had recently undergone br, participated in a questionnaire study to prospectively evaluate extramural medical and non-medical costs. estimates of mean short- and medium-term costs are presented per patient. Results: intramural medical costs forbr and short-term complications for unilateral Diep flaps (€12,848) and te/sp reconstructions (€12,400) were significantly higher than those for lD±sp reconstructions (€5804), which, in turn, were more expensive than sp reconstructions (€4731). in bilateral cases, costs of te/sp
52 ❚
(€12 723) and lD±sp (€10 760) reconstructions were comparable, while Diep flaps (€15 747) were significantly more expensive and sp reconstructions were significantly cheaper (€6784). overall, the medium-term costs for complications and additional operations were not significantly different (€3017–€4503). extramural medical costs and non-medical costs were approximately €9300 per stage, regardless of
technique. Conclusions:
Differences in short-term costs between techniques did not level out during follow-up and sp reconstructions remained least expensive. single-stage sp reconstructions, however, are not suitable for all patients due to high complication rates. Definite implant placement is therefore increasingly preceded by tissue expansion at more comparable costs to autologousbr. incorporation of non-medical costs into the cost analysis would render two- stage procedures more costly than autologous br. to achieve the optimal result, careful patient selection is critical.only in select cases where two options are equally applicable, cost comparison becomes a valid argument for treatment selection.
EVALUATION OF MESOTHERAPEUTIC INJECTIONS OF THREE DIFFERENT COMBINATIONS OF LIPOLYTIC AGENTS FOR BODY CONTOURING
Kutlubay Z. J Cosmet Laser Ther 2011; 13(4): 142–53
t
here has been signiFicant interest recently in the technique of
mesotherapy as a method of ‘melting fat’ for body contouring. Objective: the aim of this study was to evaluate the safety, efficacy and
September 2011 |
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lipolytic potential of several compounds commonly used in cosmetic mesotherapy. Methods: a total of 75 women (mean age: 33 years) were separated randomly into three mesotherapy groups.
injections were
performed for 15 treatments once a week. the main component of each cocktail was phosphatidylcholine/deoxycholic acid for group 1, caffeine for group 2, and conjonctyl® for group 3. outcome was evaluated by weight, body fat percentage (bFp), circumference measurements, and patient questionnaires. Results: seventy-two of all the patients (96%) showed a circumference loss. an average circumference reduction of 4.41 cm per site for group 1, 2.99 cm for group 2, and 2.10 cm for group 3 was achieved. Mean body circumference loss was statistically significant, with p<0.00. Weight loss was 5.33±1.09 kg for group 1, 3.74±1.51 kg for group 2, and 2.82±1.43 kg for group 3. seventy-four subjects (98.7%) showed a bFp decrease. a questionnaire indicated high patient satisfaction (63%). no patient showed irregularities, dimples or any serious side effects after treatment. Conclusion: Mesotherapy is a well-tolerated and effective alternative treatment modality for reducing the diameter of body circumference..
RELATIONSHIP AMONG LIFESTYLES, AGING AND PSYCHOLOGICALWELLBEING USING THE GENERAL HEALTH QUESTIONNAIRE 12-ITEMS IN JAPANESEWORKINGMEN
Kawada T, Otsuka T, Inagaki H et al. Aging Male 2011; 14(2): 115–8
t
he relationship aMong liFestyle, aging and psychological wellbeing was
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