| RESEARCH ROUND-UP
no influence on the incidence of complications. In conclusion, this
study
confirms in a fairly large sample that the complication rate after abdominoplasty seems to be higher in postbariatric patients compared with patients who have not had weight loss surgery. However, no predictive factors could be identified explaining these differences. Further studies need to be conducted to identify predictive factors for the occurrence of
complications after abdominal contouring surgery.
TOWARD HEALTHY AGING THROUGH EMPOWERING SELF- CARE DURING THE CLIMACTERIC STAGE
Doubova SV, Infante-Castañeda C, Martinez- Vega I, Pérez-Cuevas R. Climacteric 2012; 15(6): 563–72
develop physical and psychological health needs, calling for innovative health-care services that can be translated into preventive programs and empowerment towards self-care. Objective: To identify the changes in womenÕs discourse regarding their concerns and needs about the climacteric stage and self-care after they had participated in an integrative women-centered health-care model with empowerment for self-care. Methods: WomenÕs narratives during counseling group sessions were analyzed using qualitative inductive thematic analysis. Results: A total of 121 women between 45 and 59 years of age participated. At the beginning of the counseling group sessions, we identified the following themes: (1) Lack of information
W
HILE THEY PROGRESS THROUGH the climacteric stage, women often
FACTORS PREDICTIVE OF COMPLEX MOHS SURGERY CASES
Sahai S, Walling HW. J Dermatolog Treat 2012; 23(6): 421–27
that minimizes recurrence risk. While the indications for Mohs surgery are well established, factors predictive of complex Mohs cases are less studied. Objective: To determine patient, tumor, and surgeon characteristics associated with complex Mohs cases. Methods: A retrospective review was performed for a 3-year period (7/2006Ð 6/2009) to identify Mohs cases requiring ≥4
M
OHS SURGERY ALLOWS EXCISION OF skin cancer in a tissue-sparing fashion
about changes during the climacteric stage and self-care; (2) Tradition: the climacteric stage as a taboo subject; (3) LifeÕs changes and transitions: the complexity of the climacteric experience; (4) Stigma of menopause; (5) Relationship between the traditional gender role and the lack of self-care. At the end of the counseling group sessions, the themes were: (1) The climacteric as a natural stage; (2) Expectations for old age; (3) Empowerment and the change of awareness for self-care; (3) De-medicalization of the climacteric; (4) The richness of group work; (5) Empowerment as motivation to convey acquired knowledge. Conclusion: Women in the climacteric stage require more information about their physical, psychological and social needs, as well as the potential impact on their health during old age. Empowerment during the climacteric can contribute to improving the perception about this stage as well as the importance of self-care.
stages (Ò complexÓ ), and a control population requiring ≤3 stages (Ò non-complexÓ ). Surgical logs for four fellowship-trained Mohs surgeons were reviewed. Results: 77 complex cases (51 academic practice vs. 26 private practice) were compared with 154 control cases (102 academic practice vs. 52 private practice). There were no significant differences in patient age, gender, immunosuppression, academic (2.7% complex) versus private practice (3.5% complex), or surgeonsÕ years of experience. Factors associated with complexity included: recurrent tumors (p < 0.001; odds ratio (OR) 6.88; 95% confidence interval (CI) 2.8–17); basal cell carcinoma (BCC) with infiltrative or morpheaform histology (p = 0.0019; OR 3.0; 95% CI 1.5–6.3); tumors of the nose (p = 0.0168; OR 2.05; 95% CI 1.1–3.7), especially nasal tip (p = 0.0103; OR 3.68; 95% CI 1.3–10.6) and ear (p = 0.0178; OR 3.0; 95% CI 1.2Ð 7.9), especially helix (p = 0.00744; OR 5.9; 95% CI 1.5–22.7); tumors with pre-operative size >1 cm (p = 0.018; OR 2.0; 95% CI 1.1–3.6); and tumors involving >1 cosmetic subunit (p = 0.0072; OR 5.0; 95% CI 1.5–16.7). Complex tumors had greater post-operative area (10.6 ± 1.3 vs. 3.6 ± 0.7 cm2; p < 0.0001), and more often required flap/graft repair (p < 0.0001; OR 6.9; 95% CI 3.7–13.1). Limitations: A retrospective study representing a single geographic area. Conclusions: Mohs cases are similar in complexity whether in academic or private practice. Recurrent/aggressive histology tumors, tumors >1 cm, and tumors on the nose or ear are more likely to prove surgically complex. Advanced knowledge of these factors may be useful pre-operatively as Mohs surgeons plan their scheduled cases.
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