The pursuit of cosmetic procedures has become increasingly normalized, particularly among women and younger consumers, yet existing measures of cosmetic procedure attitudes remain limited. This research developed and validated two new scales assessing attitudes toward surgical and non-surgical procedures. In Study 1, an initial item pool was generated through focus groups and expert consultations. In Study 2, 373 women (M = 22.81, SD = 5.46) completed an online questionnaire assessing attitudes toward surgical (S) and non-surgical (NS) procedures. Exploratory factor analysis supported a three-factor structure; intrapersonal, interpersonal, and consideration, for both the 20-item surgical (CPAS-S) and 19-item non-surgical (CPAS-NS) scales. In Study 3, a new sample of 350 women (M = 21.86, SD = 4.72) completed the refined CPAS items and related psychological constructs. Confirmatory factor analysis supported the refined 16-item versions of both scales (CPAS-S and CPAS-NS). The scales demonstrated convergent, divergent, and incremental validity and showed strong test-retest reliability and agreement (N = 75, M = 21.39, SD = 4.23). For all three studies, most participants were recruited in Australia, with some recruited internationally via Prolific. Collectively, these studies provide support for contemporary, psychometrically robust tools for assessing attitudes toward surgical and non-surgical cosmetic procedures and their links with appearance-related concerns.

Total knee arthroplasty (TKA) is a surgical procedure that induces intense acute postoperative pain, but the mechanisms that amplify post-TKA pain remain incompletely understood. Endocannabinoids, such as 2-arachidonoylglycerol (2-AG), are endogenous lipids that can produce antinociceptive effects. However, hydrolysis of 2-AG by monoacylglycerol lipase (MAGL) generates arachidonic acid, the precursor to a host of eicosanoids that enhance pain. The presence of this metabolic pathway suggests that individuals with elevated 2-AG levels may be primed to develop greater postoperative pain. The primary goal of this prospective study was to determine if intraoperative 2-AG levels in the synovial fluid (SF) and cerebrospinal fluid (CSF) of TKA patients are associated with the magnitude of acute postoperative pain at rest and with ambulation. The secondary goal was to determine whether 2-AG metabolism contributes to prostaglandin E 2 (PGE 2 ) biosynthesis in synovial tissue ex vivo. Ninety subjects were enrolled in the study. SF 2-AG was positively correlated with pain at rest (r = 0.2644; P = .0157) and with ambulation (r = 0.3856; P = .0005) while CSF 2-AG was associated with pain at rest (r = 0.3312; P = .0017) but not with ambulation (r = 0.1454; P = .1871). Stratification of the results by sex revealed positive correlations between 2-AG and pain in females, which were markedly weaker or not observed in males. Ex vivo analysis demonstrated coexpression of MAGL and cyclooxygenase-2 in synovial membranes, with MAGL inhibition by MJN110 elevating 2-AG levels (median, vehicle: 0.165 nmol/g vs MJN110: 0.325 nmol/g, P = .0269) and concomitantly reducing PGE 2 (median, vehicle: 5.645 nmol/g vs MJN110: 3.440 nmol/g, P = .0425). Our findings demonstrate that patients presenting with an elevated 2-AG tone develop greater postoperative pain and position MAGL as an enzymatic node linking 2-AG metabolism with eicosanoid biosynthesis in perioperative human tissue.

Low back pain is a common pathology in the general population. In people over 60 years of age, it is associated with degenerative changes that cause narrowing of the vertebral canal. Its treatment includes conservative measures and even surgery with decompression and fusion. In those patients with moderate symptoms, the use of interspinous spacers emerged as a minimally invasive therapeutic option. This scoping review seeks to map the existing literature on the use of interspinous spacers and identify knowledge gaps to clarify their real position in the stepwise approach to low back pain. This study as a scoping review, conducted in accordance with the Joanna Briggs Institute (JBI) methodology and reported following the PRISMA-ScR guidelines. The type of synthesis chosen was descriptive and mapping-based, allowing for the inclusion of diverse study designs (randomized controlled trials, observational studies, case series, clinical guidelines, and relevant reviews) to capture a comprehensive overview of the field. This approach was selected because the existing literature is heterogeneous in terms of intervention protocols, clinical outcomes, and follow-up duration, and the effectiveness and indications for interspinous spacers (ISD) remain controversial. The search was extended from the inception of the databases until November 2025. The program "Rayyan" was used to collect the information and facilitate the analysis process. Each of the authors independently reviewed the summary of all the articles found and applied the following inclusion criteria: systematic review, clinical trials, observational studies, and case series. articles in cadavers or made in the laboratory. A total of 522 articles were found in the databases consulted, of which 95 duplicate articles were eliminated. The criteria (Inclusion/Exclusion) were applied to the 427 identified articles based on the independent reading of the abstracts by each of the authors in the Rayyan platform, and 110 articles were excluded. The 317 selected articles were reviewed completely by each of the authors to finally obtain 101 articles included in the review. The use of ISD in the treatment of moderate LSS may be controversial. Although the clinical results seem conclusive about the usefulness in controlling symptoms, more studies are needed to compare these technologies with new surgical procedures and especially new biomechanical concepts. The efforts made to treat patients with moderate LSS appropriately should continue to be channeled into optimizing techniques.

Patients with ovarian cancer often present with massive ascites, leading to significant protein loss during surgical procedures. Although cell-free concentrated ascites reinfusion therapy (CART) is used in palliative settings to mitigate protein loss, its application in intraoperative settings remains unexplored. We retrospectively evaluated patients who underwent intraoperative CART for ovarian cancer treatment between March 2022 and 2025, compared two ascitic fluid collection methods (syringe and roller pumping), and analyzed operative parameter, fluid collection efficiency, albumin recovery, and adverse event-related data. Among the 12 patients included in this study, seven (58.3%) underwent CART using the roller pumping method, which significantly reduced the collection time compared with the syringe method (9 vs. 22 min, p < 0.05). The median collection speed was also significantly higher with the roller pumping method (404 vs. 140 mL/min, p < 0.05). Approximately 70% of the albumin in the collected ascitic fluid was successfully reinfused. Adverse events included transient hypotension (16.7%) and hypertension (25.0%), both of which resolved without intervention. Intraoperative CART is a feasible and safe technique for protein loss management in patients undergoing surgery for ovarian cancer. The roller pumping method significantly shortened ascites collection time and reduced surgical burden.

Myocardial infarction (MI) is one of the leading causes of death worldwide. MI is associated with cardiac structural and functional alterations. Among these, cardiac fibrosis may be significantly influenced by mitochondrial dysfunction. We sought to evaluate whether the injection of functional mitochondria from healthy muscle could improve the detrimental consequences of MI. Male Wistar rats were submitted to MI through the ligature of the left anterior descending coronary artery. Animals subjected to a sham operation (the same surgical procedure without fastening of the suture that passes through the LAD) were included as a reference group (Sham). At the time of surgery, either vehicle (PBS) or isolated mitochondria (equivalent to 180 μg of mitochondrial protein in 75 μL of vehicle) were directly injected into the myocardium around the ligation to half of the animals in each group. Animals were sacrificed 4 weeks after both MI induction and the evaluation of cardiac and systolic functions. Cardiac mitochondrial transplantation was able to prevent the decrease in systolic function and the development of cardiac fibrosis in MI rats. These beneficial effects were accompanied by a reduction in cardiac hypertrophy, oxidative stress, endoplasmic reticulum stress activation, and inflammatory markers. We also evaluated the effects of mitochondrial transplantation by a proteomic analysis. In addition, cardiac mitochondrial transplantation was able to prevent the development of renal alterations observed in MI rats. The data reveal novel mechanisms of mitochondrial transplantation effects and emerge as a novel therapeutic strategy under chronic diseases such as MI.

Rapid reconstruction of a curved defect model within the allocated surgery time is a critical aspect of intraoperative bioprinting for cranial defect treatment. However, current data acquisition and defect reconstruction methods often involve manual intervention, which is impractical for real-time intraoperative printing due to their intricate and time-intensive nature. To tackle this challenge, this study introduces an online acquisition approach and a real-time automatic reconstruction algorithm for intraoperative defect data. Initially, a surface preprocessing scanning technique is proposed to address bone surface reflections and complex noisefrom blood and cranial tissues in live defective skulls, ensuring the acquisition of reliable defect data. Subsequently, an integrated reconstruction algorithm is developed for the obtained defect data. This algorithm seamlessly incorporates various techniques, including range filtering-based point cloud denoising, defect edge detection, patch creation utilizing the boundary-center method, and defect surface optimization based on the harmonic function. These components enable the algorithm to autonomously achieve immediate defect surface reconstruction. Finally, the effectiveness of the integrated algorithm is demonstrated through its application in surgical procedures on live rat cranial defects and human cranial defect models, showcasing its feasibility, superior accuracy, and practicality compared to software-based reconstruction methods. The algorithm is user-friendly, catering to both medical professionals and non-professionals, and fulfills the requirements of clinical intraoperative cranial treatment.

Adult granulosa cell tumor is a rare ovarian cancer with less aggressive behavior than epithelial ovarian cancer. However, recurrence occurs in up to 30% of patients and is challenging to manage, as treatment options are limited. Additionally, adult granulosa cell tumor has been linked to synchronous endometrial pathology, including endometrial hyperplasia and cancer, but the impact of these abnormalities on surgical decision-making and survival outcomes remains unclear. To evaluate how coexisting endometrial abnormalities influence surgical management and overall survival, and to examine the association between surgical extent (conservative vs complete staging) and recurrence in patients with adult granulosa cell tumor. This retrospective cohort study included all patients diagnosed with histologically confirmed ovarian adult granulosa cell tumor in Denmark between January 2007 and December 2021. Analyses were first conducted in the comprehensive nationwide Danish cohort, and results were subsequently compared in a combined analysis including data from a Dutch adult granulosa cell tumor cohort (January 2000-December 2021). Surgical procedures were categorized as complete staging (including hysterectomy, bilateral salpingo-oophorectomy, omental and peritoneal biopsies, and peritoneal washings) or less extensive surgery with clinical staging. Abnormal uterine bleeding and endometrial pathology were identified, and their associations with surgical extent and International Federation of Gynecology and Obstetrics stage were assessed. Progression-free survival was compared with surgical extent and International Federation of Gynecology and Obstetrics stage. A total of 252 Danish and 195 Dutch patients (n=447) were included, with median follow-up times of 7.2 and 3.2 years, and recurrence rates of 18% and 42%, respectively. In the Danish cohort, abnormal uterine bleeding and endometrial hyperplasia were associated with receiving less extensive surgery (odds ratio=0.35, 95% confidence interval: 0.18-0.66 and odds ratio=0.39, 95% confidence interval: 0.19-0.76). Furthermore, abnormal uterine bleeding, endometrial hyperplasia, and endometrial cancer were each associated with lower International Federation of Gynecology and Obstetrics stage at diagnosis of adult granulosa cell tumor (odds ratio=0.32, 95% confidence interval: 0.15-0.64; odds ratio=0.28, 95% confidence interval: 0.12-0.6; and odds ratio=0.16, 95% confidence interval: 0.01-0.94, respectively). In the Danish cohort, overall survival was not affected by endometrial cancer (hazard ratio=0.8, 95% confidence interval: 0.21-3.16). No difference in progression-free survival was observed between patients undergoing complete staging and those managed conservatively (hazard ratio=1.37, 95% confidence interval: 0.65-2.88). International Federation of Gynecology and Obstetrics stage IC (hazard ratio=9.4, 95% confidence interval: 4.0-22.29) and stage II-III (hazard ratio=8.4, 95% confidence interval: 2.9-24.17) had higher rates of recurrences compared with those with International Federation of Gynecology and Obstetrics stage IA or IB. Analyses of the combined Danish and Dutch cohorts demonstrated estimates consistent with those observed in the Danish cohort. The presence of abnormal uterine bleeding, endometrial hyperplasia, and endometrial cancer was associated lower International Federation of Gynecology and Obstetrics stage, suggesting that these factors facilitate earlier detection of adult granulosa cell tumor without adversely affecting overall survival. Complete surgical staging is not associated with improved progression-free survival in patients with adult granulosa cell tumor. Higher International Federation of Gynecology and Obstetrics stage (IC or higher) was, as expected, associated with an increased rate of recurrence compared to stage IA and IB.

Silver sulfadiazine-cerium nitrate burn wound foam dressing stabilizes eschar by reducing local inflammation and controlling burn wound infections.

Research progress in surgery-related meibomian gland dysfunction

To compare ultrasonographic and histopathological measurements of tumor size in enucleated eyes with choroidal melanoma and to evaluate the prognostic significance of tumor dimensions and morphological characteristics in a Serbian cohort. This retrospective study included 59 consecutive patients with histopathologically confirmed choroidal melanoma who underwent enucleation at the University Eye Hospital, Clinical Centre of Serbia. All ultrasonographic examinations, surgical procedures, and histopathological assessments were performed by single dedicated subspecialists. Preoperative B-scan ultrasonography was used to measure tumor base diameter and thickness, which were compared with postoperative macroscopic histopathological dimensions using paired statistical tests, Bland-Altman analysis, and intraclass correlation coefficients (ICC). Survival outcomes were assessed using Pearson and Spearman correlations and Kaplan-Meier analysis. Patients were followed for a minimum of 1 year, with some monitored for up to 5 years. Data are presented as mean ± SD. The mean ultrasonographic base diameter and thickness were 14.63 ± 3.98 and 10.34 ± 3.54 mm, respectively, compared with 18.04 ± 6.54 and 10.55 ± 3.72 mm on pathology. Bland-Altman analysis demonstrated good agreement for tumor thickness (mean difference 0.2 mm; limits of agreement -5.5 to +5.5 mm) and acceptable agreement for base diameter (mean difference 3.4 mm; limits -8.2 to +15.1 mm). ICC indicated moderate agreement for base diameter (0.501) and excellent agreement for thickness (0.843). Pathological thickness correlated significantly with shorter metastasis-free survival ( r = -0.293, P = 0.024). Kaplan-Meier analysis showed significantly poorer survival for patients with T3-T4 tumors. Ultrasonography provides a reliable preoperative estimation of choroidal melanoma size, particularly for tumor thickness, although histopathology remains essential for prognostication. Survival patterns in this cohort align with international data, highlighting the relevance of tumor thickness and morphology and emphasizing the value of data from an underrepresented region.

The medical comorbidities associated with trisomy 21 (T21) often necessitate multiple surgical and imaging procedures requiring general anesthesia, with perioperative complications occurring at a higher frequency than their age-matched peers. Combining multiple procedures by unrelated specialists under a single anesthetic is often suggested as a method to reduce anesthetic risks during induction, airway manipulation and emergence, in addition to potentially decreasing health care costs and time burdens on patients and families, but the safety advantage of this strategy has not been demonstrated. To evaluate the association of multispecialty case strategies with perioperative safety events in children with T21. At Children's Wisconsin, we performed 219 626 anesthesia cases in 120 299 patients over a span of 9.6 years, compared to 3873 cases in 995 patients with T21. Of this cohort, 2871 cases were single specialty in nature while 1002 (17.5%) cases were multispecialty. Compared to the whole anesthesia population, the T21 cohort had a notably higher likelihood of multiple anesthetics per patient (OR = 8.02 [95% CI 7.11-9.04] p < 0.001), multispecialty care (OR = 3.95 [95% CI 3.6-4.3] p < 0.001), and risk of perioperative safety events (OR = 5.65 [95% CI 4.51-7.08] p < 0.001). The T21 cohort had lower age and weight, higher ASA-PS, more organ-based pathology, longer anesthesia case times, more cases, and higher multispecialty exposure per case. Detailed demographic comparison of the T21 cohort to the anesthesia population is shown in TableS2. Multivariable logistic regression identified independent risk factors associated with perioperative events as ASA-PS 4 (OR = 4.5 [95% CI 1.4-14.5]) or 5 (OR = 85.5 [95% CI 22.8-320.3]), Black or African American race (OR = 1.98 [95% CI 1.2-3.3]), anesthesia time (OR = 1.22 [95% CI 1.1-1.3]), and multispecialty case (OR = 2.6 [95% CI 1.6-4.3]); however, there was no increased risk with number of anesthetics per patient. No attempts were made to evaluate whether the families perceived benefit of either practice. Multispecialty care is a highly utilized method of providing care for children with T21 within our institution, often used to ease the scheduling burden and risk of these children and families. Understanding the risk associated with this practice by parents and care providers may lead to a more thoughtful scheduling practice. With this understanding, patients in need of multispecialty care may benefit by either considering a single specialty case or limit multispecialty scheduling to a 4-h duration.

People worldwide use risky, potentially harmful cosmetic procedures to change their appearance. The newly developed Risky Appearance Altering Behaviours Inventory (RAABI) measures interest and engagement in appearance-altering behaviours, including surgical and non-surgical cosmetic procedures, diet pills, skin bleaching and hair straightening. RAABI items were constructed based on focus groups across diverse cultural contexts. Using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), exploratory structural equation modelling (ESEM) and bifactor ESEM, we examined the psychometric properties of the RAABI among women from the UK (N = 784, Mage = 27.8, SD = 12.09) and Colombia (N = 589, Mage = 21.43, SD = 2.96). We examined construct validity, composite reliability and longitudinal reliability (test-retest and invariance over 2 weeks), and assessed the fit of an extended Tripartite Influence Model (TIM) including the RAABI as an outcome alongside eating disorder (ED) symptoms. The RAABI demonstrated good composite reliability, construct validity, and indications of longitudinal reliability. In both countries, a 12-item, three-factor ESEM structure with good psychometric properties emerged, although item composition differed (UK included tanning, Colombia included skin bleaching items). Bifactor models were psychometrically adequate, showing a strong general factor with three subscales in Colombia, and a moderate general factor in the UK. The extended TIM showed good fit with RAABI included as an outcome measure. Overall, the RAABI (used as a total score or via subscales) is a psychometrically valid measure for assessing additional negative outcomes of sociocultural pressures, appearance ideal internalisation and body dissatisfaction in the UK and Colombia.

Peripheral nerve injury is a complex condition that significantly impacts quality of life and often affects young and active individuals. Accurate classification of injury severity using the Sunderland grading system is essential for distinguishing cases amenable to conservative management from those that require surgical intervention. While lower-grade injuries are typically managed conservatively at first, persistent or severe symptoms frequently necessitate surgery. Surgical approaches vary depending on the underlying cause of the nerve injury, including compressive neuropathies, trauma, and neoplastic lesions, and may involve nerve decompression, transposition, neurolysis, nerve repair techniques, and tumor resection. Imaging evaluation with high-frequency US and MRI is fundamental for postoperative peripheral nerve assessment, allowing direct nerve visualization, evaluation of the surgical site and persistent signs of nerve injury, identification of secondary changes such as muscle denervation, and differentiation between the expected postoperative findings and complications. These complications include perineural fibrosis, neuroma formation, incomplete decompression, nerve graft failure, and surgical site collections. It is crucial for radiologists to understand the spectrum of normal postoperative changes and recognize abnormal findings to avoid misinterpretation, optimize patient care, and guide clinical decision making after peripheral nerve surgery. The authors aim to provide a comprehensive review of the main peripheral nerve surgical procedures, with a focus on the surgical techniques, expected postoperative imaging appearances, and spectrum of potential complications.

Clinical features and outcomes of fungal bone and joint infections in Western France.

To maintain the visual potential of individuals with open globe injuries, anatomical integrity must be restored. Preventing further tissue damage and preserving corneal shape to reduce the resulting postoperative astigmatism are the major goals of initial repair surgery. We present a case of 70-year-old male patient reporting to the OPD of Department of Ophthalmology, with the chief complaint of pain, diminution of vision in left eye and dropping of the left eyelid since two days, due to trauma from bull’s horn. The patient was diagnosed with aphakia/open globe injury and underwent three surgical procedures for the rectification of complaint. First procedure was globe injury tear repair, second was scleral tuck lens implantation and finally scleral tuck lens explantation with reimplantation. The three surgeries took place till two months after reporting of the chief complaint.

Functional and psychosocial outcomes of simultaneous condylectomy and bimaxillary orthognathic surgery for unilateral condylar hyperplasia: Retrospective study.

Bariatric surgery effectively treats severe obesity. However, long-term data on weight maintenance and patient well-being remain scarce. This study assessed patients' perspectives on their bariatric trajectory and outcomes of their historical and current status across multiple domains, irrespective of surgical procedure. A retrospective cohort study was conducted among patients who were referred to the Department of Medical Psychology for bariatric screening between 1998 and 2004. Of the 547 referred patients, eligible participants received a survey after informed consent addressing weight outcomes, current eating patterns, dietary guidelines adherence, expectation fulfillment, satisfaction, and peer advice. Sixty-two participants completed survey. Mean postoperative time since the initial surgery was 19 years (range 6-27). Mean preoperative weight decreased 33%, from 144.2 to 97.5kg. Preoperative Body Mass Index decreased from 50.3 to 34.0kg/m2. Healthy postoperative behaviors included regular meals, portion control and control regarding snacking between meals. Unhealthy behaviors included evening snacking, alcohol consumption and binge eating. One third reported using vitamins never or sometimes. Participants reported diverse encountered barriers regarding eating, drinking, physical and psychological health and social functioning. Most would choose surgery again except those with expectation-outcome discrepancies or ongoing weight instability. Peer advice emphasized comprehensive preoperative education on all potential postoperative consequences from multiple sources. After 19 years, weight loss, healthy eating and adherence to advice varied, yet most participants were satisfied regardless of weight loss or reoperation. We plea for lifelong follow-up care to optimize bariatric results regardless type of surgery.

Thoracic esophageal perforation (EP) is a life-threatening emergency. While minimally invasive techniques have been successfully utilized, the heterogeneity of clinical presentations (perforation location, delays in treatment, tissue quality, etc.) has prevented the establishment of a standardized management approach. We present our experience with a minimally invasive management protocol combining thoracoscopy and endoscopy. Between December 2023 and January 2025, 5 patients with thoracic EP underwent a thoracoscopic approach. Primary closure via direct suturing, lavage, and drainage was performed when feasible. Persistent leaks were addressed with endoscopic interventions, including vacuum-assisted therapy and stent placement. A retrospective review of patient medical records was conducted. Of the five perforations, four were right-sided, and one was left-sided. Three cases were spontaneous, while two were iatrogenic (one following bariatric surgery and the other after endoscopic dilation). One patient had a perforation associated with malignancy, and another was on long-term high-dose steroid therapy. Management was initiated within 24 hours after the onset of symptoms in 3 patients and after 48 hours in 2 patients. Persistent leaks occurred in 3 patients (two late presentations and one corticosteroid impregnation). There were no fatalities. Esophageal preservation was achieved in all cases, and all patients resumed oral intake by the end of follow-up. Thoracic EP can be effectively managed using minimally invasive techniques. Avoiding thoracotomy and complex surgical procedures may offer significant benefits for critically ill patients.

Management of facial nerve during parotid recurrent pleomorphic adenoma revision surgery.

An overview of recent flexible- and soft-biomaterial applications in myocardial infarction and other cardiovascular diseases.