High Level Of Patient Satisfaction Research Articles

Surgical Removal of Fat Nodules Formed in the Tear Trough After Autologous Fat Grafting.

Autologous fat grafting is a common treatment for tear trough deformities. This procedure involves a potential complication of fat nodule formation, leading to abnormal bulging of the lower eyelid. However, limited information exists about this complication, and an effective treatment is lacking. The present study aimed to present a novel surgical approach for the removal of fat nodules caused by autologous fat grafting in the tear trough. This retrospective study included 33 patients who underwent surgery for the removal of fat nodules formed after autologous fat grafting. The procedure was performed using a conjunctival approach, allowing exposure and removal of all fat nodules in the anterior septal space, with the method adapted according to the severity of the deformity. A total of 66 eyelids were treated surgically, including 30 (45.45%) with mild nodular deformity, 23 (34.85%) with moderate nodular deformity, and 13 (10.70%) with severe nodular deformity. A second surgical procedure was required on 3 eyelids (4.56%). The main complications of the surgery were conjunctival congestion (21.21%), and localized depression (18.18%), bruising (12.12%). Among the patients, 29 (87.88%) were satisfied and 4 (12.12%) were dissatisfied with the treatment results. Conjunctival approach surgery is an effective method of removing fat nodules formed after autologous fat grafting in the tear trough, with good results and high levels of patient satisfaction. This approach enables the effective management of a common complication of autologous fat grafting and may enable the wider application of autologous fat grafting in the periorbital region. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Can narrow-diameter implants enhance patient-reported outcomes for mandibular implant-retained overdentures?

A systematic review and meta-analysis. To evaluate and compare stability and functionality between narrow and standard implant-retained mandibular overdentures in edentulous patients from multiple perspectives. Assessments included clinical parameters [survival rate (SR) and marginal bone loss (MBL)], along with patient-reported outcome measures (PROMs) including patient satisfaction and oral health-related quality of life (OHRQoL). The study protocol followed PRISMA criteria for reporting reviews and meta-analyses. Using appropriate keywords, electronic search was conducted in each of the following databases: Medline, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus, up to July 22, 2022. There were no restrictions based on language, publication type, or publication date. Additionally, ongoing studies were explored in ClinicalTrials.gov and WHO ICTRP, while cross-references in each selected study were manually examined. The eligible studies were randomized controlled trials (RCTs) or controlled clinical trials (CCTs) comparing narrow implants (diameter ≤ 3.5 mm) to standard implants (diameter > 3.5-4.5 mm) retaining mandibular overdentures in edentulous patients. Excluded were studies with unclear implant diameter information, fewer than 5 patients per group, observational studies, reviews, and laboratory studies. Two authors independently conducted study selection, data collection, and analysis, resolving any discrepancies through discussion with a third author. Methodological quality was assessed using RoB-2 and ROBINS-I tools. Implant SR and MBL measurements at final follow-up were recorded, while patient satisfaction and OHRQoL were evaluated using visual analogue scale (VAS-100) and oral health impact profile (OHIP) questionnaire, respectively. After duplicate removal, 782 publications and 83 registered clinical trials were identified, of which 26 were eligible for full-text assessment. Ultimately, the quantitative evaluation included 12 publications from 8 independent studies: 4 parallel design RCTs and 4 CCTs. Risk of bias assessment revealed variations among the studies, with only one study being rated as having low risk. The follow-up periods ranged from 1 to 3 years. Meta-analysis showed no significant difference in SR and MBL between narrow and standard implant groups (p = 0.29 and p = 0.93, respectively), with considerable heterogeneity (I2 = 100% and I2 = 78%, respectively). Regarding PROMs, the narrow implant group showed significantly higher levels of patient satisfaction (mean difference (MD): 8.18; 95% CI: 5.83 to 10.53; p < 0.00001; I2 = 36%) and exhibited a significant improvement in OHRQoL (MD: -4.36; 95% CI: -6.83 to -1.89; p < 0.001; I2 = 55%) compared to the standard implant group. For implant-retained mandibular overdentures, the use of narrow implants is associated with comparable SR and MBL, along with higher patient satisfaction and better OHRQoL improvement as compared to standard implants, offering a viable alternative option for patients with diminished alveolar bone width.

From Awareness to Action: Clinicians and the Health Care of Deaf Patients

High levels of patient satisfaction are critical in health care and allow patients to feel more satisfied with their care and be more compliant overall. This idea is even more important in traditionally disenfranchised groups of people, such as Deaf patients, because satisfaction with medical encounters can translate into better health outcomes. This community possesses its own traditions, language, and culture, and health disparities here are apparent and often significant. Clearer communication in clinical encounters allows for more accessible health care. Barriers to effective communication are a major factor accounting for poorer health outcomes for Deaf individuals.

Immediate versus early loading of immediately placed bone-level tapered dental implants with hydrophilic surface in full arch maxillary rehabilitation: A pilot randomized clinical trial with 2-year follow-up.

This study aimed to compare implant stabilities between the immediate and early loaded, immediately placed bone-level tapered dental implants in the maxilla and to evaluate marginal bone loss (MBL), oral health-related quality of life (OHRQoL), and patient satisfaction at a 2-year follow-up. A pilot, prospective, randomized, controlled clinical trial was conducted on 24 maxillary failing dentition patients. The bone-level tapered implants of 12 patients were immediately loaded with temporary restorations, while the other 12 patients did not receive any kind of temporization. Implant-supported screw-retained complete porcelain-fused-to-metal prostheses were delivered to all patients in the seventh postoperative week. The insertion torque values of implants assigned to the immediate and early loading groups were 33.0 ± 4.87 and 29.26 ± 8.31 Ncm, respectively. The dynamics of implant stability changes from implant placement up to a 2-year follow-up were similar for both groups (Penguin®, p = 0.268; Ostell®, p = 0.552), while the MBL was at submillimeter level. The cumulative implant survival rate was 91.80% for immediately loaded implants and 97.22% for early loaded implants, without significant difference (p = 0.162). The total score on the Oral Health Impact Profile questionnaire significantly decreased over time in both groups, indicating improvement in OHRQoL (p < 0.001), and the high level of patient satisfaction remained after 2 years of function regardless of a loading protocol. Both loading protocols, immediate and early, of six immediately placed bone-level tapered dental implants are an adequate treatment choice for fixed rehabilitation of the maxillary failing dentition.

Comparison of recurrence rate of primary pterygium using conjunctival autograft with sutures versus suture-free approach.

Objective: To compare the recurrence rate of primary pterygium treated with conjunctival autograft (CAG) using sutures versus a suture-free approach. Methodology: From July 2022 to December 2022, a quasi-experimental study was carried out at the Institute of Ophthalmology, Liaquat University of Medical &amp; Health Sciences Jamshoro. A total of 110 patients with primary pterygium underwent treatment with conjunctival autograft using sutures or a suture-less/glue-free approach, under local anaesthesia. The patients were monitored for 12 months after surgery to assess recurrence and complications, and all procedures were performed by a single surgeon. Data was collected and analyzed on SPSS version 22. Result: The study included 110 patients with pterygium, mostly males (71.81%) and from rural areas, with the nasal location being the most common. Group A had 3 recurrences at 3 and 6 months, while Group B had 4 recurrences at similar intervals. Group A had fewer complications, including graft oedema, retraction, granuloma, and giant papillary conjunctivitis, while Group B had three cases of retraction. The recurrence rate was found to be 5.08% and 7.70% with and without sutures (P value ≥ 0.53) respectively. Conclusion: The excision of primary pterygium using conjunctival autograft with sutures or suture-free/glue-free methods are safe and uncomplicated procedure that results in lower levels of induced astigmatism, improved cosmetic appearance, no tissue loss, reduced recurrence of pterygium, and decreased risk of, scleral thinning, granuloma formation. Suture-free conjunctival autograft results in less postoperative manifestation like discomfort foreign body sensation, shorter surgery time, and high levels of patient satisfaction compared to conjunctival autograft with sutures. Key words: Primary pterygium, autograft and pterygium. recurrence rate of pterygium, suture with pterygium.

Influence of pain duration and severity on oral health-related quality of life and patient satisfaction during adult treatment with clear aligners

BackgroundThis study aims to compare the impact of pain on quality of life and patient satisfaction during treatment with aligners.MethodsNinety-four subjects in active treatment were invited to answer self-reported questions concerning pain severity and duration, occurrence of other signs and symptoms, and level of satisfaction with their treatment. Also, the OHIP-14 questionnaire was applied to assess patients’ OHRQoL.ResultsNinety-four patients (49 women and 45 men) answered the survey. Pain duration of 1–3 days was reported by 69.1% of patients (n = 60). For those who reported pain (n = 84), it was considered mild severity by 42.9% and moderate by 52.4%. Almost sixty-four percent of the sample were very satisfied with the aligner’s aesthetics (n = 60) and forty-nine percent were satisfied with treatment in general (n = 46). Mean OHIP-14 score was 3.36 ± 2.54. OHRQoL was significantly associated with pain severity, whereas patients who reported having experienced moderate pain presented a significantly higher mean OHIP-14 score than those who reported having experienced mild pain (3.92 ± 1.93 and 2.69 ± 2.83, respectively; p = 0.036). The “psychological discomfort” OHIP-14’s domain was the most influenced by the level of pain.ConclusionPain severity significantly influenced OHRQoL, in adult patients under treatment with clear aligners. However, high levels of patient satisfaction were reported, regardless of pain duration or severity.

ANALYSIS OF THE DIMENSIONS OF HEALTH SERVICE QUALITY ON PATIENT SATISFACTION AT ROYAL PRIMA MARELAN HOSPITAL IN 2024

One indicator of quality in health services is patient satisfaction, where high-quality health services will generally create a high level of patient satisfaction, leading to loyalty to health services. The study aimed to analyze the dimensions of Health Service Quality toward Patient Satisfaction at Royal Prima Marelan Hospital in 2024. The method used in this research is quantitative non-experimental with a descriptive approach (cross-sectional survey) and associative analysis. The population was 318 people, and the sample determination used Slovin so that the sample size was 197, rounded up to 200 samples, with incidental sampling technique-data analysis using univariate, bivariate (Chi-Square), multivariate (multiple logistic regression Enter method). The results of the Chi-Square analysis obtained the variables of Physical Evidence (p-value 0.004), reliability (p-value 0.006), Responsiveness (p-value 0.008), assurance (p-value 0.004), empathy (p-value 0.002) have a p-value ≤ 0.05 with a significant level of 0.05. It is concluded that the most influential variable is the empathy variable, with a p-value of 0.000 &lt;0.05. The OR value obtained is 10.224, meaning that ease of relationship, good communication, and understanding of the needs of patients have an opportunity of 10.224 times to increase patient satisfaction at Royal Prima Marelan Hospital in 2024. KEYWORDS: quality, satisfaction, patient, empathy

Application and effect of tension-reducing suture in surgical treatment of hypertrophic scar

PurposeTo investigate the application and effectiveness of tension-reducing suture in the repair of hypertrophic scars.MethodsA retrospective analysis of clinical data was conducted on 82 patients with hypertrophic scars treated at the Department of Burns and Plastic Surgery of Nanjing Drum Tower Hospital from September 2021 to December 2022. Patients were operated with combination of heart-shaped tension-reducing suturing technique and looped, broad, and deep buried (LBD) suturing technique or conventional suture method. Outcomes of surgical treatment were assessed before and 6 months after surgery using the Patient and Observer Scar Assessment Scale (POSAS) and the Vancouver Scar Scale (VSS).ResultsImprovements were achieved on scar quality compared to that preoperatively, with a reduction in scar width (1.7 ± 0.6 cm vs. 0.7 ± 0.2 cm, P < 0.001). Assessment using the POSAS and VSS scales showed significant improvements in each single parameter and total score compared to preoperative values (P < 0.05). The Combination method group achieved better score in total score of VSS scale, in color, stiffness, thickness and overall opinion of PSAS scale, and in vascularity, thickness, pliability and overall opinion of OSAS scale.ConclusionThe amalgamation of the heart-shaped tension-reducing suturing technique and the LBD suturing technique has shown promising outcomes, garnering notably high levels of patient satisfaction in the context of hypertrophic scar repair. Patients have exhibited favorable postoperative recoveries, underscoring the clinical merit and the prospective broader applicability of this approach in the realm of hypertrophic scar management.

Ceramic-on-Ceramic Total Hip Arthroplasty Using a Double Tapered, Proximally Coated Stem: 15 to 24-year Clinical and Radiologic Follow-Up

BackgroundTotal hip arthroplasty implant choice profoundly affects survivorship, complications, and failure modes. This study evaluates the long-term (average 18 year) outcomes of ceramic-on-ceramic hip arthroplasty using uncemented shells and stems. Despite an impressive 20-year cumulative percent revision of 5.9%, the hydroxyapatite proximally coated femoral components evaluated in this study have seen declining use since 2003. MethodsA review of 349 consecutive total hip arthroplasties from 1999 to 2007 was matched to 272 cases with registry data. A survivorship analysis included 274 hips (Group A) after excluding patients lost to follow-up and navigated cases. Group B comprised 135 patients who had complete datasets spanning a minimum of 15 years. ResultsKaplan-Meier analysis identified a 95.6% survivorship plateau at 16 to 24 years, with no significant impact from age, sex, component size, or original pathology. In Group B, EuroQol-5 Dimensions-5 Levels (EQ5D5L) scores indicated favorable outcomes in mobility, self-care, activities, pain/discomfort, and anxiety/depression, with an EQ5D visual analog score mean of 79.24. Functional scores, including the Harris Hip Score, Oxford Hip Score, and Forgotten Joint Score, showed positive outcomes. Radiologic assessments revealed no osteolysis or loose components, with a mean Engh score of 21.69. Dorr classification identified bone quality variations. Better Engh scores corresponded to higher levels of patient satisfaction. Age at surgery was correlated with better functional scores, while sex influenced various outcomes. ConclusionsThis comprehensive study, spanning an average of 18.23 years, combined multiple patient-reported outcome measures with extensive clinical and radiologic follow-up. It reported a notably high survivorship rate for this implant combination but highlighted the declining use of the hydroxyapatite proximally coated femoral stem used in this study, potentially facing withdrawal risks in Australia. Level of evidenceTherapeutic Level IV.

0606 Post Market Surveillance from Precision OAT Cases Indicates High Levels of Patient and Provider Satisfaction

0606 Post Market Surveillance from Precision OAT Cases Indicates High Levels of Patient and Provider Satisfaction

Long-term assessment of collagenase treatment for Dupuytren’s contracture: A 10-year follow-up study

BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum (CCH) has revolutionized the treatment for Dupuytren’s contracture (DC). Despite its benefits, the long-term outcomes remain unclear. This study presented a comprehensive 10-year follow-up assessment of the enduring effects of CCH on patients with DC. AIM To compare the short-term (12 wk) and long-term (10 years) outcomes on CCH treatment in patients with DC. METHODS A cohort of 45 patients was treated with CCH at the metacarpophalangeal (MCP) joint and the proximal interphalangeal (PIP) joint and underwent systematic re-evaluation. The study adhered to multicenter trial protocols, and assessments were conducted at 12 wk, 7 years, and 10 years post-surgery. RESULTS Thirty-seven patients completed the 10-year follow-up. At 10 years, patients treated at the PIP joint exhibited a 100% recurrence. However, patients treated at the MCP joint only showed a 50% recurrence. Patient satisfaction varied, with a lower satisfaction reported in PIP joint cases. Recurrence exceeding 20 degrees on the total passive extension deficit was observed, indicating a challenge for sustained efficacy. Significant differences were noted between outcomes at the 7-year and 10-year intervals. CONCLUSION CCH demonstrated sustained efficacy when applied to the MCP joint. However, caution is warranted for CCH treatment at the PIP joint due to a high level of recurrence and low patient satisfaction. Re-intervention is needed within a decade of treatment.

Advancements in Aesthetic Breast Augmentation: Evaluating the Safety, Efficacy, and Naturalistic Outcomes of Ergonomix2 Implants.

This pioneering study evaluates the safety, efficacy, and Aesthetic outcomes of Ergonomix2 Motiva Ergonomic Implants in breast augmentation. It aims to assess their capability to offer more natural touch and dynamics, delineate the learning curve for surgical techniques, and examine their safety profile compared to Ergonomix1 implants. A prospective cohort study was conducted, comparing 31 patients who received Ergonomix2 implants with a control group of 51 patients with Ergonomix1 implants. Eligible patients were those seeking Aesthetic breast augmentation without prior surgeries or chronic illnesses. Detailed documentation of surgical techniques, implant characteristics, and patient demographics was performed. The study assessed surgical learning curve, implant positioning accuracy, and short-term and early complications. Aesthetic outcomes were evaluated using the BreastQ questionnaire and quantitative elastography. Patients with Ergonomix2 implants showed significant improvements in Aesthetic outcomes, including breast contour symmetry and natural feel. The learning curve demonstrated a decrease in surgical time and higher implant positioning accuracy. The safety profile was favorable, with a low complication rate and high patient satisfaction levels. Ergonomix2 implants exhibited enhanced softness and pliability, closely mimicking natural breast tissue, as confirmed by elastographic analyzes. Ergonomix2 implants represent a significant advancement in Aesthetic breast surgery, offering natural-feeling and dynamically adaptable outcomes. Despite the promising results, the need for specialized surgical techniques and further research on long-term safety and efficacy is emphasized. This study contributes foundational knowledge to the field of ergonomic breast implants and their application in modern plastic surgery. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Open clinical trial evaluating the efficacy of a novel eyelash growth enhancer with peptides and glycosaminoglycans.

Eyelashes play a crucial role in self-image and ocular protection. Enhancements to their structure are of both cosmetic and clinical interest. To assess the efficacy of a peptide and glycosaminoglycan-based eyelash enhancer serum in improving eyelash structure. This open-label clinical trial involved 30 females aged 25-65. Eyelashes were assessed at baseline (D0), 4 weeks (D28), and 12 weeks (D84) using specialized software and high-resolution imagery. Measurements included lash number, width, length, volume, arc, and angle. At 12 weeks, significant increases were observed in lash length (+8.3%), number (+5%), width (+10.1%), volume (+14.1%), arc (+13.4%), and angle (+28.3%) compared to baseline. Global Eyelash Assessment (GEA) scores significantly improved, and patient treatment satisfaction increased from 73.34% at D28 to 84.33% at D84. No adverse effects were reported. The eyelash growth enhancer serum demonstrated significant efficacy in improving eyelash structure by Week 12, with early signs of improvement evident by Week 4. The high patient satisfaction levels underscore the perceived effectiveness of the product.

Achieving Harmonious Feminine Proportions: A Comprehensive Study on Breast Harmonization with Nanotextured Implants.

The prevalence of breast augmentation as a strategy for achieving idealized feminine proportions, consistent with contemporary beauty standards, has increased notably. This study focuses on the use of nanotextured implants, examining their efficacy in enhancing body symmetry and conforming to current aesthetic ideals. Conducted as a prospective cohort study, this research included women who underwent breast augmentation using nanotextured ergonomic implants from 2017 to 2023. A personalized methodology was applied, incorporating an array of anthropometric measurements and individual motivations to inform the selection of implants. The techniques used aimed at fostering a natural aesthetic, coupled with an extensive postoperative follow-up to evaluate outcomes and identify any complications. The study involved 1000 participants, with findings indicating a marked improvement in breast and overall body proportions, in line with targeted aesthetic principles. High levels of patient satisfaction were observed, with more than 90% reporting favorable aesthetic results and a low incidence of complications. These findings emphasize the effectiveness and safety of nanotextured implants in achieving the desired aesthetic goals. The study underscores the efficacy of nanotextured implants in attaining balanced feminine proportions, aligning surgical results with modern beauty ideals and enhancing personal well-being. It highlights the significance of a tailored approach in breast augmentation, which encompasses not only the physical aspects of aesthetic enhancement but also the psychological and social facets of patient contentment.

Abstract P317: Patient Perceptions and Satisfactions of a Remote Blood Pressure Monitoring Program in an Integrated Healthcare System

Background: Uncontrolled high blood pressure (BP) is a leading contributor to cardiovascular disease. Remote BP monitoring (RBPM) can empower patients to participate in their healthcare which may be important for improving BP control. The aim of this study was to understand patients’ attitudes toward and satisfaction with a RBPM program. Methods: We identified Kaiser Permanente (KP) Southern California members aged 18 years and older enrolled in a RBPM program. Eligibility criteria include having uncontrolled BP (≥140/90 mmHg), a smartphone, and an email address. Between July 27 and August 17, 2023, we emailed a letter of invitation and link to an online survey to 716 eligible members followed by 2 reminder emails. The survey consisted of 5 domains to assess patients’ experiences with a BP monitor and the KP Health Ally app: ease of use, trust, perceived benefits, privacy and overall satisfaction. Responses to each question were rated on a scale from 1 (disagree) to 7 (agree). The average score for each domain was calculated as the weighted sum of the questions. Antihypertensive medication adherence was reported on a scale ranging from “all of the time” to “less than half the time”. Results: A total of 71 patients (9.9%) responded to the survey with 60 (8.4%) completing all questions. Respondents had a mean age of 60.4 (SD 13.1) years, with 70.4% being female and 50.5% African American. Overall satisfaction and perceived benefits were the highest scoring domains followed by ease of use and trust in the monitor and app (Figure). Privacy concerns were minimal. The overwhelming majority of respondents (89.7%) reported taking their BP medications all or nearly all of the time. Conclusion: Most respondents rated the RBPM program with a high level of satisfaction, perceived benefits and had limited concern about privacy with the potential opportunity to improve patients’ trust in the BP monitor and app functionality. This high level of patient satisfaction and acceptability should lead to increased implementation and scaling of the RBPM program.

Influence of medical and social factors on patients’ satisfaction at the center for reproduction and family planning with medical care

BACKGROUND: The constant increase in the number of commercial medical organisations providing medical care using assisted reproductive technology (ART) and compulsory medical insurance funds necessitates the need to control the quality of medical services in this area. An important tool for this control is conducting sociological surveys of women undergoing infertility treatment using in vitro fertilisation (IVF) both in paid and free forms.&#x0D; MATERIALS AND METHODS: Using a random sampling method, an anonymous survey was conducted on 398 patients of the Center for Reproduction and Family Planning in St. Petersburg, which provided medical care for infertility treatment using ART both at the expense of compulsory medical insurance and in paid form. The significance of differences in indicators was assessed using Student’s t-test for quantitative indicators. The significance of differences between qualitative characteristics was checked using contingency tables and Pearson’s chi-square test (χ2). Differences were considered significant at р 0.05.&#x0D; RESULTS: Despite the high level of patient satisfaction with the provision of medical care using ART, 9.0% of women were partially or completely dissatisfied. Compulsory medical insurance funds were paid for infertility treatment using IVF for 12.1% of patients. The majority of patients paid for medical care themselves (87.9%), of which 13.1% of women believed that the cost of medical services in the center was excessive (χ2=29.08; р=0.000), and 10.9% thought that the cost does not correspond to the level of medical services provided (χ2=25.74; р=0.000). There was no significant influence of age (χ2=4.78; р=0.311), place of residence (χ2=1.79; р=0.409), presence of children (χ2=2.21; р=0.331), employment (χ2=2.91; р=0.233) and forms of payment for treatment (χ2=4.69; р=0.096) on the distribution of patients according to the degree of satisfaction with medical care. At the same time, it was determined that marital status (χ2=6.88; р=0.032) and income level (χ2=60.01; р=0.000) are factors that influence the degree of satisfaction of women with infertility treatment using ART.&#x0D; CONCLUSION: Many medical and social factors have been identified to significantly affect satisfaction with medical care, such as the patient’s marital status and income level. Simultaneously, the economic form of payment for treatment did not have a significant effect on the degree of satisfaction.

Home- vs clinic-based daylight photodynamic therapy with 5-aminolevulinic acid nanoemulsion (BF-200 ALA) for actinic keratosis: A randomized, single-blind, prospective study

BackgroundDaylight photodynamic therapy (DL-PDT) has become one of the most effective treatments for the resolution of actinic keratosis (AK) of Olsen grade 1 and 2. Generally, PDT it is carried out in a clinic setting, which involves the patient's and their caregivers commuting to the hospital as well as a significant use of resources to carry it out within the clinic setting. ObjectivesTo determine the efficacy and safety of a home-based treatment of AK with DL-PDT with the BF-200 ALA gel compared to a clinic-based setting. MethodsThe study was performed as a randomized, single-center, non-inferiority clinical trial with two parallel groups. 9 patients received one clinic-based DL-PDT (group 1) and 11 patients received one session of home-based DL-PDT (group 2). The primary endpoints were the mean AK clearance per patient and the total AK lesion clearance rate 12 weeks after treatment. The secondary endpoints were the number of remaining AKs and new AKs appearing in the treatment field 12 weeks after one PDT session. The pain during and 24 h after PDT as well as the local skin reactions were also assessed. ResultsThe overall reduction of AK lesions per patient was similar in both groups with one PDT session. An overall AK clearance per patient of 10 ± 4.33 for group 1 versus 9.73 ± 2.9 for group 2 without statistically significant differences (p = 0.868). Regarding the clearance rate, although it was slightly higher in group 2 (71.58 ± 22.51 vs 82.1 ± 11.13), the analysis did not show statistically significant differences. The mild pain recorded during the treatment course and the mild local skin reactions were similar in both groups. Patient satisfaction was high for both groups without statistically significant differences. ConclusionSelf-performed home-based DL-PDT with BF-200 ALA gel is as effective as the one performed in a clinic-based setting, with a comparable safety profile, high levels of patient satisfaction and with advantages for the patients and their caregivers that can enhance patient´s adherence to the treatment

Algorithmic Midline Approach to Perineal Urethrostomy is Associated With Long-term Success and High Patient Satisfaction

PurposeTo assess surgical success and patient-reported outcomes of perineal urethrostomy via midline approach. Materials & MethodsCharts of patients undergoing primary perineal urethrostomy between May 2008 and June 2022 were reviewed. Background characteristics were assessed; success was defined as freedom from re-intervention. Patient-reported outcome measures were assessed using a cross-sectional phone survey. Several validated questionnaires were used to assess lower urinary tract symptoms, quality of life, and erectile dysfunction. ResultsAmong 1,768 urethroplasties performed over the study period, 103 patients (5.8%) underwent midline perineal urethrostomy. Surgery was successful in 95.1% of cases (98/103); 5 patients (4.9%) required re-intervention at a median of 8.7 months. Post-operative complications occurred in 5.8% of cases (6/103) and were both mild and self-limited.Forty-nine patients (47.6%) were reached via phone survey at a median of 61 months post-operatively. Some questions were not answered by all patients. Most patients (42/49, 86%) were satisfied or very satisfied with surgical results, and 82% (40/49) reported an improvement in their overall health. Most patients (31/41, 76%) were unbothered by sitting to urinate. Although 20% of patients (10/49) reported post-operative urinary symptoms that interfered “a lot” with their daily life, only 3 (6%) of these patients reported dissatisfaction with outcome. Regarding sexual function, 64% (27/42) reported indifference to or increased satisfaction with sexual encounters versus before surgery. The rate of de novo ED was 24% (12/49). ConclusionsThe midline approach to perineal urethrostomy provides excellent, durable success rates with high levels of patient satisfaction.

Techniques in Nipple Areolar Reconstruction: A Retrospective Analysis of Surgical Interventions and Patient-reported Satisfaction Scores.

Nipple areolar complex (NAC) reconstruction often signifies completion of the breast reconstruction process for some patients and has been shown to improve both psychosocial and sexual well-being. Several techniques have been described; however, there currently exists little evidence in the literature describing outcomes or patient satisfaction. A retrospective analysis of NAC reconstructions over the last decade was queried for patient demographics, operative technique, and postoperative outcomes. A standardized, validated survey was also utilized to evaluate overall satisfaction, with a focus on aesthetic outcome, shape, color, and projection. Eighty-three patients were identified, with 49 (59.0%) completing the survey. The modalities used for reconstruction include the C-V flap (45.7%), the modified skate flap technique (42.2%), and free nipple grafting (FNG, 12.0%). No significant differences in age, BMI, or comorbidities were found among the three types. The most utilized donor site for skate flap reconstruction was the suprapubic area (37.1%). There were also no significant differences in complication rate (C-V 10.5%, FNG 10%, skate 5.7%, P = 0.630) or revision surgery (C-V 2.6%, FNG 0%, skate 5.7%, P = 0.732). The most common complication was nipple necrosis. Adjusting for time to follow-up using multivariate analysis, there was a significant difference in overall patient satisfaction when compared across all three techniques, with the modified skate flap having the highest mean overall satisfaction scores. NAC reconstruction can be completed safely and effectively with a variety of techniques. The modified skate flap technique was associated with high levels of patient satisfaction and a low complication rate.

Effectiveness of a novel consultant nurse-led breast pain clinic in secondary care.

Patients with breast pain are usually seen in 'one-stop clinic' (OSC) with breast imaging. In the absence of associated red flag features, the incidence of breast cancer is extremely low. With increase in referrals the OSC capacity is over-stretched. We developed a consultant nurse-led dedicated 'breast pain clinic' in September 2021 without routine breast imaging. After meticulous history and examination, patients obtained detailed counselling and advice regarding breast pain management. If any abnormality was noted then appointment was given for OSC. To assess the effectiveness of a consultant nurse-led dedicated 'breast pain clinic'. A prospective study of all consecutive patients seen in 'breast pain clinic' from September 2021 until September 2022. Feedback was sought from all patients. Altogether 429 patients were seen. The mean age was 48.7years (range 18-86). 87.6% (n = 376) patients required no breast imaging. Only 12.4% (n = 53) patients needed referral to OSC and subsequently 2 patients (0.46%) were diagnosed with breast cancer. Ninety-eight percent of patients felt reassured and 99.2% patients were extremely likely/likely to recommend this service to family and friends. Out of 376 patients who were discharged from breast pain clinic, 12 patients were referred again over a median follow-up period of 15months, and 2 out of them were diagnosed with breast cancer. A consultant nurse-led 'breast pain clinic' provides service improvement as it eases the pressure on the OSC. Most patients were managed without breast imaging with high level of patient satisfaction and low rereferral rate.