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Publisher: Springer-Verlag   (Total: 2335 journals)

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Showing 1201 - 1400 of 2335 Journals sorted alphabetically
J. of Communications Technology and Electronics     Hybrid Journal   (Followers: 1, SJR: 0.267, h-index: 14)
J. of Community Genetics     Hybrid Journal   (Followers: 1, SJR: 0.699, h-index: 8)
J. of Community Health     Hybrid Journal   (Followers: 8, SJR: 0.676, h-index: 39)
J. of Comparative Physiology A: Neuroethology, Sensory, Neural, and Behavioral Physiology     Hybrid Journal   (Followers: 7, SJR: 0.98, h-index: 63)
J. of Comparative Physiology B : Biochemical, Systemic, and Environmental Physiology     Hybrid Journal   (Followers: 3, SJR: 0.981, h-index: 50)
J. of Compassionate Health Care     Open Access   (Followers: 1)
J. of Computational Analysis and Applications     Hybrid Journal   (SJR: 0.284, h-index: 16)
J. of Computational Electronics     Hybrid Journal   (Followers: 3, SJR: 0.457, h-index: 17)
J. of Computational Neuroscience     Hybrid Journal   (Followers: 19, SJR: 1.419, h-index: 54)
J. of Computer and Systems Sciences Intl.     Hybrid Journal   (SJR: 0.252, h-index: 11)
J. of Computer Science and Technology     Open Access   (Followers: 5, SJR: 0.342, h-index: 26)
J. of Computer Virology and Hacking Techniques     Hybrid Journal   (Followers: 5)
J. of Computer-Aided Molecular Design     Hybrid Journal   (Followers: 4, SJR: 0.951, h-index: 70)
J. of Computers in Education     Hybrid Journal   (Followers: 5)
J. of Computing in Higher Education     Hybrid Journal   (Followers: 12, SJR: 0.725, h-index: 16)
J. of Consumer Policy     Hybrid Journal   (Followers: 3, SJR: 0.44, h-index: 23)
J. of Contemporary Mathematical Analysis     Hybrid Journal   (SJR: 0.115, h-index: 4)
J. of Contemporary Physics (Armenian Academy of Sciences)     Hybrid Journal   (Followers: 1, SJR: 0.174, h-index: 4)
J. of Contemporary Psychotherapy     Hybrid Journal   (Followers: 4, SJR: 0.441, h-index: 16)
J. of Control Theory and Applications     Hybrid Journal   (Followers: 2, SJR: 0.406, h-index: 13)
J. of Control, Automation and Electrical Systems     Hybrid Journal   (Followers: 6, SJR: 0.168, h-index: 8)
J. of Crop Science and Biotechnology     Hybrid Journal   (Followers: 7)
J. of Cross-Cultural Gerontology     Hybrid Journal   (Followers: 3, SJR: 0.412, h-index: 23)
J. of Cryptographic Engineering     Partially Free   (Followers: 5, SJR: 0.757, h-index: 6)
J. of Cryptology     Hybrid Journal   (Followers: 2, SJR: 1.598, h-index: 49)
J. of Cultural Economics     Hybrid Journal   (Followers: 2, SJR: 0.445, h-index: 24)
J. of Database Marketing & Customer Strategy Management     Hybrid Journal   (Followers: 8, SJR: 0.183, h-index: 5)
J. of Derivatives & Hedge Funds     Hybrid Journal   (Followers: 8, SJR: 0.207, h-index: 3)
J. of Developmental and Physical Disabilities     Hybrid Journal   (Followers: 8, SJR: 0.615, h-index: 23)
J. of Digital Imaging     Hybrid Journal   (Followers: 8, SJR: 0.535, h-index: 29)
J. of Direct Data and Digital Marketing Practice     Hybrid Journal   (Followers: 6, SJR: 0.296, h-index: 3)
J. of Dynamical and Control Systems     Hybrid Journal   (Followers: 2, SJR: 0.556, h-index: 22)
J. of Dynamics and Differential Equations     Hybrid Journal   (SJR: 1.33, h-index: 29)
J. of Earth Science     Hybrid Journal   (Followers: 6, SJR: 0.299, h-index: 11)
J. of Earth System Science     Open Access   (Followers: 28, SJR: 0.466, h-index: 27)
J. of East Asian Linguistics     Hybrid Journal   (Followers: 5, SJR: 0.669, h-index: 15)
J. of Echocardiography     Hybrid Journal   (Followers: 3, SJR: 0.136, h-index: 3)
J. of Economic Growth     Hybrid Journal   (Followers: 25, SJR: 5.251, h-index: 54)
J. of Economic Interaction and Coordination     Hybrid Journal   (SJR: 0.231, h-index: 11)
J. of Economics     Hybrid Journal   (Followers: 9, SJR: 0.463, h-index: 20)
J. of Economics and Finance     Hybrid Journal   (Followers: 7, SJR: 0.238, h-index: 15)
J. of Educational Change     Hybrid Journal   (Followers: 7, SJR: 0.694, h-index: 14)
J. of Elasticity     Hybrid Journal   (Followers: 4, SJR: 0.821, h-index: 38)
J. of Electroceramics     Hybrid Journal   (SJR: 0.566, h-index: 49)
J. of Electronic Materials     Hybrid Journal   (Followers: 2, SJR: 0.752, h-index: 68)
J. of Electronic Testing     Hybrid Journal   (Followers: 2, SJR: 0.241, h-index: 24)
J. of Electronics (China)     Hybrid Journal   (Followers: 3, SJR: 0.127, h-index: 7)
J. of Elementary Science Education     Hybrid Journal   (Followers: 8)
J. of Engineering Mathematics     Hybrid Journal   (SJR: 0.707, h-index: 32)
J. of Engineering Physics and Thermophysics     Hybrid Journal   (Followers: 1, SJR: 0.132, h-index: 8)
J. of Engineering Research     Open Access  
J. of Engineering Thermophysics     Hybrid Journal   (Followers: 1, SJR: 0.294, h-index: 7)
J. of Environmental Studies and Sciences     Partially Free   (Followers: 2)
J. of Ethology     Hybrid Journal   (Followers: 2, SJR: 0.484, h-index: 21)
J. of Evolution Equations     Hybrid Journal   (SJR: 1.312, h-index: 22)
J. of Evolutionary Biochemistry and Physiology     Hybrid Journal   (SJR: 0.127, h-index: 9)
J. of Evolutionary Economics     Hybrid Journal   (Followers: 8, SJR: 0.878, h-index: 42)
J. of Experimental and Theoretical Physics     Hybrid Journal   (Followers: 2, SJR: 0.565, h-index: 34)
J. of Experimental Criminology     Hybrid Journal   (Followers: 28, SJR: 1.587, h-index: 22)
J. of Failure Analysis and Prevention     Hybrid Journal   (Followers: 5, SJR: 0.256, h-index: 12)
J. of Family and Economic Issues     Hybrid Journal   (Followers: 6, SJR: 0.532, h-index: 27)
J. of Family Violence     Hybrid Journal   (Followers: 15, SJR: 0.552, h-index: 45)
J. of Financial Services Marketing     Hybrid Journal   (Followers: 3, SJR: 0.241, h-index: 6)
J. of Financial Services Research     Hybrid Journal   (Followers: 16, SJR: 1.196, h-index: 29)
J. of Fixed Point Theory and Applications     Hybrid Journal   (SJR: 0.467, h-index: 10)
J. of Fluorescence     Hybrid Journal   (Followers: 3, SJR: 0.553, h-index: 47)
J. of Food Measurement and Characterization     Hybrid Journal   (SJR: 0.104, h-index: 1)
J. of Food Science and Technology     Hybrid Journal   (Followers: 5, SJR: 0.839, h-index: 21)
J. of Forest Research     Hybrid Journal   (Followers: 3, SJR: 0.578, h-index: 22)
J. of Forestry Research     Hybrid Journal   (Followers: 6, SJR: 0.271, h-index: 10)
J. of Fourier Analysis and Applications     Hybrid Journal   (Followers: 1, SJR: 1.248, h-index: 36)
J. of Friction and Wear     Hybrid Journal   (Followers: 6, SJR: 0.263, h-index: 6)
J. of Fusion Energy     Hybrid Journal   (Followers: 3, SJR: 0.389, h-index: 16)
J. of Gambling Studies     Hybrid Journal   (Followers: 3, SJR: 1.122, h-index: 50)
J. of Gastroenterology     Hybrid Journal   (Followers: 13, SJR: 1.724, h-index: 73)
J. of Gastrointestinal Cancer     Hybrid Journal   (Followers: 3, SJR: 0.371, h-index: 36)
J. of Gastrointestinal Surgery     Hybrid Journal   (Followers: 5, SJR: 1.632, h-index: 87)
J. of General Internal Medicine     Hybrid Journal   (Followers: 13, SJR: 2.379, h-index: 115)
J. of General Plant Pathology     Hybrid Journal   (SJR: 0.357, h-index: 17)
J. of Genetic Counseling     Hybrid Journal   (Followers: 4, SJR: 0.535, h-index: 32)
J. of Genetics     Open Access   (Followers: 4, SJR: 0.42, h-index: 24)
J. of Geodesy     Hybrid Journal   (Followers: 8, SJR: 4.049, h-index: 48)
J. of Geographical Sciences     Hybrid Journal   (Followers: 1, SJR: 0.58, h-index: 14)
J. of Geographical Systems     Hybrid Journal   (Followers: 3, SJR: 0.839, h-index: 32)
J. of Geometric Analysis     Hybrid Journal   (SJR: 1.496, h-index: 23)
J. of Geometry     Hybrid Journal   (Followers: 1, SJR: 0.349, h-index: 13)
J. of Global Optimization     Hybrid Journal   (Followers: 4, SJR: 0.919, h-index: 51)
J. of Global Policy and Governance     Hybrid Journal   (Followers: 8)
J. of Grid Computing     Hybrid Journal   (SJR: 0.727, h-index: 32)
J. of Hand and Microsurgery     Hybrid Journal   (Followers: 1)
J. of Happiness Studies     Hybrid Journal   (Followers: 14, SJR: 0.785, h-index: 30)
J. of Hematopathology     Hybrid Journal   (Followers: 3, SJR: 0.194, h-index: 11)
J. of Heuristics     Hybrid Journal   (Followers: 5, SJR: 1.718, h-index: 43)
J. of High Energy Physics     Hybrid Journal   (Followers: 4, SJR: 1.027, h-index: 139)
J. of Homotopy and Related Structures     Hybrid Journal   (SJR: 0.102, h-index: 1)
J. of Housing and the Built Environment     Hybrid Journal   (Followers: 6, SJR: 0.553, h-index: 21)
J. of Huazhong University of Science and Technology [Medical Sciences]     Hybrid Journal   (SJR: 0.317, h-index: 15)
J. of Ichthyology     Hybrid Journal   (Followers: 4, SJR: 0.28, h-index: 7)
J. of Immigrant and Minority Health     Hybrid Journal   (Followers: 8, SJR: 0.573, h-index: 29)
J. of Inclusion Phenomena and Macrocyclic Chemistry     Hybrid Journal   (Followers: 1, SJR: 0.459, h-index: 41)
J. of Indian Philosophy     Hybrid Journal   (Followers: 10, SJR: 0.179, h-index: 7)
J. of Indian Prosthodontic Society     Open Access   (SJR: 0.165, h-index: 5)
J. of Industrial Microbiology and Biotechnology     Hybrid Journal   (Followers: 10, SJR: 1.064, h-index: 68)
J. of Industry, Competition and Trade     Hybrid Journal   (Followers: 7, SJR: 0.411, h-index: 11)
J. of Infection and Chemotherapy     Hybrid Journal   (Followers: 1, SJR: 0.65, h-index: 39)
J. of Information Technology     Hybrid Journal   (Followers: 45, SJR: 1.659, h-index: 43)
J. of Information Technology Teaching Cases     Hybrid Journal   (Followers: 5)
J. of Infrared, Millimeter and Terahertz Waves     Hybrid Journal   (Followers: 1, SJR: 0.902, h-index: 31)
J. of Inherited Metabolic Disease     Hybrid Journal   (Followers: 2, SJR: 1.182, h-index: 66)
J. of Inorganic and Organometallic Polymers and Materials     Partially Free   (Followers: 6, SJR: 0.316, h-index: 27)
J. of Insect Behavior     Hybrid Journal   (Followers: 9, SJR: 0.537, h-index: 36)
J. of Insect Conservation     Hybrid Journal   (Followers: 9, SJR: 0.775, h-index: 36)
J. of Intelligent and Robotic Systems     Hybrid Journal   (Followers: 2, SJR: 0.501, h-index: 36)
J. of Intelligent Information Systems     Hybrid Journal   (Followers: 1, SJR: 0.427, h-index: 39)
J. of Intelligent Manufacturing     Hybrid Journal   (Followers: 4, SJR: 1.095, h-index: 44)
J. of Interventional Cardiac Electrophysiology     Hybrid Journal   (SJR: 1.073, h-index: 38)
J. of Intl. Business Studies     Hybrid Journal   (Followers: 25, SJR: 4.835, h-index: 108)
J. of Intl. Entrepreneurship     Hybrid Journal   (Followers: 8, SJR: 0.489, h-index: 16)
J. of Intl. Migration and Integration / Revue de l integration et de la migration internationale     Hybrid Journal   (Followers: 12, SJR: 0.385, h-index: 9)
J. of Intl. Relations and Development     Hybrid Journal   (Followers: 19, SJR: 0.35, h-index: 15)
J. of Labor Research     Hybrid Journal   (Followers: 14, SJR: 0.228, h-index: 21)
J. of Logic, Language and Information     Hybrid Journal   (Followers: 5, SJR: 0.63, h-index: 20)
J. of Low Temperature Physics     Hybrid Journal   (Followers: 1, SJR: 0.773, h-index: 48)
J. of Machinery Manufacture and Reliability     Hybrid Journal   (Followers: 2, SJR: 0.194, h-index: 4)
J. of Mammalian Evolution     Hybrid Journal   (Followers: 5, SJR: 1.845, h-index: 32)
J. of Mammary Gland Biology and Neoplasia     Hybrid Journal   (Followers: 1, SJR: 3.22, h-index: 73)
J. of Management and Governance     Hybrid Journal   (Followers: 12, SJR: 0.383, h-index: 26)
J. of Management Control     Hybrid Journal   (Followers: 4, SJR: 0.134, h-index: 4)
J. of Marine Science and Application     Hybrid Journal   (Followers: 3, SJR: 0.343, h-index: 8)
J. of Marine Science and Technology     Hybrid Journal   (Followers: 3, SJR: 0.317, h-index: 22)
J. of Maritime Archaeology     Hybrid Journal   (Followers: 21, SJR: 0.19, h-index: 5)
J. of Market-Focused Management     Hybrid Journal   (Followers: 2)
J. of Marketing Analytics     Hybrid Journal   (Followers: 2)
J. of Material Cycles and Waste Management     Hybrid Journal   (Followers: 3, SJR: 0.392, h-index: 16)
J. of Materials Engineering and Performance     Hybrid Journal   (Followers: 24, SJR: 0.666, h-index: 31)
J. of Materials Science     Hybrid Journal   (Followers: 18, SJR: 1.006, h-index: 101)
J. of Materials Science : Materials in Electronics     Hybrid Journal   (Followers: 3, SJR: 0.697, h-index: 48)
J. of Materials Science : Materials in Medicine     Hybrid Journal   (Followers: 4, SJR: 0.926, h-index: 77)
J. of Mathematical Biology     Hybrid Journal   (Followers: 13, SJR: 1.183, h-index: 61)
J. of Mathematical Chemistry     Hybrid Journal   (Followers: 5, SJR: 0.407, h-index: 41)
J. of Mathematical Fluid Mechanics     Hybrid Journal   (Followers: 5, SJR: 1.709, h-index: 17)
J. of Mathematical Imaging and Vision     Hybrid Journal   (Followers: 3, SJR: 1.25, h-index: 44)
J. of Mathematical Modelling and Algorithms     Hybrid Journal   (Followers: 2, SJR: 0.358, h-index: 19)
J. of Mathematical Sciences     Hybrid Journal   (SJR: 0.32, h-index: 20)
J. of Mathematics Teacher Education     Hybrid Journal   (Followers: 13, SJR: 1.042, h-index: 14)
J. of Maxillofacial and Oral Surgery     Hybrid Journal   (Followers: 2)
J. of Mechanical Science and Technology     Hybrid Journal   (Followers: 4, SJR: 0.589, h-index: 20)
J. of Medical and Biological Engineering     Hybrid Journal   (SJR: 0.434, h-index: 13)
J. of Medical Humanities     Hybrid Journal   (Followers: 18, SJR: 0.251, h-index: 13)
J. of Medical Systems     Hybrid Journal   (Followers: 2, SJR: 0.604, h-index: 32)
J. of Medical Toxicology     Hybrid Journal   (Followers: 6, SJR: 0.765, h-index: 21)
J. of Medical Ultrasonics     Hybrid Journal   (Followers: 2, SJR: 0.209, h-index: 11)
J. of Medicine and the Person     Hybrid Journal  
J. of Membrane Biology     Hybrid Journal   (Followers: 1, SJR: 0.971, h-index: 75)
J. of Micro-Bio Robotics     Hybrid Journal  
J. of Microbiology     Hybrid Journal   (Followers: 7, SJR: 0.641, h-index: 35)
J. of Mining Science     Hybrid Journal   (Followers: 5, SJR: 0.296, h-index: 11)
J. of Molecular Evolution     Hybrid Journal   (Followers: 11, SJR: 1.07, h-index: 99)
J. of Molecular Histology     Hybrid Journal   (Followers: 2, SJR: 0.791, h-index: 43)
J. of Molecular Medicine     Hybrid Journal   (Followers: 15, SJR: 2.452, h-index: 100)
J. of Molecular Modeling     Hybrid Journal   (Followers: 4, SJR: 0.55, h-index: 42)
J. of Molecular Neuroscience     Partially Free   (Followers: 8, SJR: 1.242, h-index: 61)
J. of Mountain Science     Hybrid Journal   (Followers: 3, SJR: 0.295, h-index: 11)
J. of Muscle Research and Cell Motility     Hybrid Journal   (Followers: 1, SJR: 1.052, h-index: 51)
J. of Nanoparticle Research     Hybrid Journal   (Followers: 3, SJR: 0.777, h-index: 66)
J. of Natural Medicines     Hybrid Journal   (SJR: 0.586, h-index: 22)
J. of Near-Death Studies     Hybrid Journal   (Followers: 2)
J. of Nephrology     Hybrid Journal   (Followers: 5, SJR: 0.857, h-index: 48)
J. of Network and Systems Management     Hybrid Journal   (SJR: 0.331, h-index: 23)
J. of Neural Transmission     Hybrid Journal   (Followers: 2, SJR: 1.302, h-index: 77)
J. of Neuro-Oncology     Hybrid Journal   (Followers: 3, SJR: 1.342, h-index: 80)
J. of Neuroimmune Pharmacology     Hybrid Journal   (Followers: 1, SJR: 1.239, h-index: 36)
J. of Neurology     Hybrid Journal   (Followers: 13, SJR: 1.406, h-index: 91)
J. of NeuroVirology     Hybrid Journal   (Followers: 1, SJR: 1.367, h-index: 63)
J. of Nondestructive Evaluation     Hybrid Journal   (Followers: 7, SJR: 0.452, h-index: 22)
J. of Nonlinear Science     Hybrid Journal   (Followers: 1, SJR: 1.772, h-index: 36)
J. of Nonverbal Behavior     Hybrid Journal   (Followers: 3, SJR: 1.122, h-index: 38)
J. of Nuclear Cardiology     Hybrid Journal   (SJR: 1.456, h-index: 60)
J. of Nutrition, Health and Aging     Hybrid Journal   (Followers: 18, SJR: 0.886, h-index: 50)
J. of Obstetrics and Gynecology of India     Hybrid Journal   (Followers: 7, SJR: 0.174, h-index: 3)
J. of Occupational Rehabilitation     Hybrid Journal   (Followers: 11, SJR: 1.166, h-index: 43)
J. of Ocean Engineering and Marine Energy     Hybrid Journal   (Followers: 1)
J. of Ocean University of China (English Edition)     Hybrid Journal   (SJR: 0.144, h-index: 8)
J. of Oceanography     Hybrid Journal   (Followers: 7, SJR: 1.031, h-index: 46)
J. of Ocular Biology, Diseases, and Informatics     Hybrid Journal   (SJR: 0.228, h-index: 8)
J. of Optical and Fiber Communications Reports     Hybrid Journal   (Followers: 2, SJR: 0.831, h-index: 2)
J. of Optics     Hybrid Journal   (Followers: 4)
J. of Optimization Theory and Applications     Hybrid Journal   (Followers: 3, SJR: 0.928, h-index: 55)
J. of Ornithology     Hybrid Journal   (Followers: 21)
J. of Orofacial Orthopedics / Fortschritte der Kieferorthop√§die     Hybrid Journal   (SJR: 0.667, h-index: 27)
J. of Orthopaedic Science     Hybrid Journal   (Followers: 5, SJR: 0.684, h-index: 42)
J. of Paleolimnology     Hybrid Journal   (Followers: 5, SJR: 1.284, h-index: 58)
J. of Parasitic Diseases     Hybrid Journal   (Followers: 2, SJR: 0.272, h-index: 5)
J. of Pediatric Neuropsychology     Hybrid Journal  
J. of Pest Science     Hybrid Journal   (Followers: 2, SJR: 1.002, h-index: 21)
J. of Pharmaceutical Health Care and Sciences     Open Access  
J. of Pharmaceutical Innovation     Hybrid Journal   (Followers: 8, SJR: 0.617, h-index: 14)
J. of Pharmaceutical Investigation     Hybrid Journal   (Followers: 1, SJR: 0.16, h-index: 2)
J. of Pharmacokinetics and Pharmacodynamics     Hybrid Journal   (Followers: 22, SJR: 0.567, h-index: 41)
J. of Phase Equilibria and Diffusion     Hybrid Journal   (Followers: 19, SJR: 0.367, h-index: 31)

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Journal Cover European Journal of Plastic Surgery
  [SJR: 0.171]   [H-I: 14]   [6 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1435-0130 - ISSN (Online) 0930-343X
   Published by Springer-Verlag Homepage  [2335 journals]
  • Levels of evidence in plastic surgery—bibliometric trends and
           comparison with five other surgical specialties
    • Abstract: Background Categorising research by level of evidence (LOE) is an important evidence-based medicine initiative. Our objective was to assess the change in LOEs in plastic surgery from 2003 to 2013 and compared this with five other surgical specialties. Methods A search for all research articles published in the top three general plastic surgery journals (ranked by impact factor) was conducted for 2003 and 2013. Articles were then labelled as LOE 1–5 and compared to other specialties. Results Mean LOE for plastic surgery improved by 4.1 % from 3.86 (95 % confidence interval 3.81–3.91) to 3.70 (95 % confidence interval 3.64–3.74) from 2003 to 2013 respectively. All six surgical specialties improved their mean LOE (range 3.7 to 10.9 %). By mean LOE, plastic surgery continues to rank five out of six. Conclusions Plastic surgery is tending towards higher levels of evidence at a slow pace. The specialty must continue to drive towards higher levels of evidence. Level of Evidence: Not ratable.
      PubDate: 2016-07-18
       
  • Signet ring adenocarcinoma of the colon presenting as an orbital
           metastasis
    • Abstract: Abstract A 67-year-old woman was referred after MRI imaging revealed an infiltrative, diffusely enhancing left intraconal lesion. Ophthalmic examination revealed a left proptosis, resistance to globe retropulsion, and restriction of extraocular motility in all fields of gaze. The result of a biopsy via an orbitotomy was consistent with signet ring adenocarcinoma. PET scanning was significant for lytic vertebral and rib lesions and activity within the cecum. Colonoscopy confirmed the diagnosis of stage 4 colonic adenocarcinoma. Although colon carcinoma presenting as an extraconal orbital metastasis has been reported, this is the first reported case of signet ring adenocarcinoma of the colon presenting as an intraconal orbital metastasis without eyelid involvement. Orbital metastatic disease from known primary malignancies is uncommon and in particular from carcinomas arising from the gastrointestinal tract. When metastatic orbital disease is found, studies have reported that as high as 42 % of these patients have an undiagnosed primary malignancy. This allows orbital surgery to play a role detecting as yet undiagnosed carcinomas. Level of Evidence: Level V, diagnostic study.
      PubDate: 2016-07-15
       
  • Assessment and planning for oncoplastic and reconstructive breast surgery:
           a review and a proposed chart
    • Abstract: Abstract Assessment for oncoplastic and reconstructive breast surgery (ORBS) can be time-consuming and subjective with a prolonged learning curve. Further, lack of recognition of options may lead to loss of patient choices whether available locally or not. This article reviews and incorporates essential variables into an author-designed chart with components of clinic consultation (“History” and “Examination”) that classify individual cases into one of the three complexities: high, average and low. Based on these complexities, decision-making processes are discussed in order to achieve, safely and realistically, both subjective and objective (anticipated versus achieved) goals of ORBS. This article by summarising literature around common ORBS variables attempts to streamline decision-making process as well as charts out variables to facilitate audit of decision-making and case selection process. Level of Evidence: Not ratable
      PubDate: 2016-07-14
       
  • Surgical stabilization for symptomatic carpometacarpal hypermobility; a
           randomized comparison of a dorsal and a volar technique and a cohort of
           the volar technique
    • Abstract: Background Hypermobility of the first carpometacarpal joint is mostly surgically treated with a volar approached stabilization by Eaton, but recent studies indicate the importance of the dorsoradial and intermetacarpal ligaments (DRL and IML) for carpometacarpal joint stability. The aim of this study was to compare a dorsal and volar technique for primary carpometacarpal hypermobility regarding pain and functional outcome. Methods Patients with non-degenerative, painful carpometacarpal hypermobility were included and were randomly assigned to either the volar technique using the FCR, or a dorsal technique using the ECRL. After premature termination of the trial, we followed all patients treated with the volar approach. Pain, strength, and ADL function using DASH and Michigan Hand Questionnaires (MHQ) were measured at baseline and 3 and 12 months after surgery. Results After including 16 patients, the randomized trial comparing the volar and dorsal technique was terminated because of significant increased pain in the dorsal group. Although none of the other outcome measures were significant in the underpowered comparison, in line with the pain scores, all variables showed a trend towards a worse outcome in the dorsal group. Between 2009 and 2012, 57 thumbs were surgically stabilized. We found significant better pain and MHQ scores, and after 1 year improved grip and key pinch strength. Patients returned to work within 8 (±7) weeks, of which 85 % in their original job. Conclusions Surgical stabilization of the thumb is an effective method for patients suffering from hypermobility regarding pain, daily function, and strength. We recommend a volar approach. Level of Evidence: Level I, therapeutic study
      PubDate: 2016-07-13
       
  • Three-dimensional soft tissue analysis of the hand: a novel method to
           investigate effects of acromegaly
    • Abstract: Background Acral overgrowth is a highly common clinical sign in patients with active acromegaly. To what extent this overgrowth persists after long-term remission of acromegaly is largely unknown. Using the new imaging technique of three-dimensional (3D) stereophotogrammetry, it is possible to accurately investigate soft tissue changes of the hand. The aim of the recent study was to compare the 3D soft tissue characteristics of the hands of patients in long-term remission of acromegaly to those of a healthy pair matched control group. Methods A case-control study was performed at a tertiary referral center. Twelve patients in remission of acromegaly (58 % male, mean age 58.3 years, mean BMI 29.6 kg/m2) were compared to twelve age-, gender-, ethnicity-, and BMI-matched control subjects. Of each individual, 3D photographs of both hands were acquired and analyzed using a 3D computer software program. Results The patients in long-term remission of acromegaly have overgrowth of soft tissue of the hand compared to matched control subjects, with a larger length and width of the hand (p = 0.0025, p = 0.0017, respectively). Furthermore, the diameters measured at the proximal interphalangeal (PIP) joints of the individual fingers are larger in the acromegaly patients. Conclusions Significant soft tissue overgrowth of the hand persists in former acromegaly patients, even after long-term remission. Analysis of 3D hand photographs is an accurate and easy tool to evaluate the acral soft tissue patterns in acromegaly. Level of Evidence: Level III, diagnostic study.
      PubDate: 2016-07-12
       
  • Nose clefts: own experience of treatment with different types of
           congenital nasal anomalies
    • Abstract: Background Nose cleft is a rare congenital malformation. According to the Tessier classification, it can appear as a part of craniofacial cleft numbers 0, 1, 2, or 3. However, it can also be observed as an isolated nose cleft. The aim of this study was to present our experience in the treatment of isolated cleft nasal deformity. Methods A retrospective study of all patients with isolated nose cleft treated at our clinic between years 1995 and 2015 was undertaken. The collected data included age, sex, type of cleft, coexisting malformations, and methods of treatment. Results Over a period of 20 years, 28 patients with isolated cleft nasal deformity (11 males and 17 females)were treated. In the examined group, there were 21 patients with median nose cleft and seven with cleft of the ala nasi. Patients from the median nose cleft group were operated on in two or three stages. In the first stage, a procedure involving soft tissue and nose cartilage was performed, while in the second phase, rhinoplasty with osteotomy was performed. One patient had his treatment accomplished in three stages. Patients from the ala nasi cleft group underwent procedures performed with methods of local plasty or flap rotation. Conclusions Nose clefts are characterized by a variable clinical picture (midline cleft vs ala nasi cleft and total cleft vs partial cleft). The nose cleft is not always a part of craniofacial clefts as isolated forms of such malformations can also occur. This type of congenital anomaly requires always an individual treatment plan. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2016-07-12
       
  • Umbilical reconstruction with the bow tie flap
    • Abstract: Abstract The umbilicus can be absent in congenital malformations that are associated to umbilical agenesia such as bladder exstrophy, gastroschisis or omphalocele or it can be excised during surgical procedures such as umbilical herniorrhaphy, abdominoplasty and laparotomy. We report a new technique for umbilical reconstruction, using a “bow tie”-shaped flap, partially made of scar tissue. We treated three female patients with absent umbilicus as a consequence of congenital malformations or previous surgical treatments. This method provided a good conical shape to the neoumbilicus with adequate depth and a wide external ring. Follow-up at 2 years showed that a satisfactory shape was maintained. Previously described techniques for neoumbilicoplasty were unsatisfying or seemed too complex in our hands. The reported technique is easy and simple, with good, stable and natural aesthetic results, and it can be effectively used for umbilical reconstruction in all primary or secondary cases of umbilical absence. Level of evidence: Level V, therapeutic study.
      PubDate: 2016-07-02
       
  • Versatility of lateral arm flap for hand reconstruction—a clinical
           experience
    • Abstract: Background The lateral arm free flap (LAFF) has several advantages in hand reconstruction due to multiple factors. We aimed to show the versatility of LAFF in treating hand defects. Methods A retrospective analysis of all LAAF for hand reconstruction carried out at our institutions between August 2006 and August 2012 was undertaken. Clinical records were reviewed with respect to patients’ age and gender, size and location of defect, type and size of flaps, and complications. Results Twenty-four hand defects were reconstructed using LAFF. These included 15 cutaneous flaps, 8 fascial flaps, and 1 osteocutaneous flap. All flaps survived well except for one case that developed arterial insufficiency and required anastomotic revision. Primary closure of the donor site was possible in all patients. No complications occurred during the healing procedure. Conclusions The free lateral arm flap is a versatile and reliable option for defect coverage at the hand for small- and medium-size defects. It can be raised as a cutaneous, fascial, or osteocutaneous flap. Several advantages favor the use of lateral arm flap in hand reconstruction. These include preservation of major arm blood vessels, its constant vascular anatomy, long pedicle, and low donor site morbidity. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2016-07-02
       
  • Bipedicle transverse lumbar fasciocutaneous flap: a useful surgical
           technique for the cover of lumbar defects
    • Abstract: Abstract Lumbar defects constitute a challenging problem for practicing plastic surgeons. With an increase in spinal surgeries and a rising number of war victims, newer and better plastic solutions are required to cover wounds in the lumbar region. Vertically oriented paraspinal musculocutaneous flaps have been described for central lumbar back defects. This article describes a horizontally oriented bipedicle fasciocutaneous flap that can also be used to cover large transverse defects. The versatility of this flap in treating a case of a war victim is highlighted. Level of Evidence: Level V, therapeutic study.
      PubDate: 2016-06-29
       
  • Complications caused by injection of dermal filler in Danish patients
    • Abstract: Background The usage of dermal fillers has increased significantly in recent years. Soft tissue augmentation with fillers helps to diminish the facial lines and to restore volume and fullness in the face at a relatively low cost. With the increasing number of treatments, the number of complications is likely to increase as well. Methods A total of 37 patients with complications were collected retrospectively during a period of 13 years using original data files. Information on the type, date, number and location of the injections, type and date of complications, treatment, bacteria, and pathology were registered. Results The most commonly injected material in this series was Polyacrylamide (35.1 %) and Hyaluronic Acid (18.9 %). Most of the patients had filler injected in the lips (54.1 %), periorally (40.5 %), and in the cheek area (29.7 %). The median period between filler injection and complications was 2 years (range 1 day–8 years). The most common reported complications were edema (81 %), noduli (67.7 %), infections (54.1 %), discoloration (51.4 %), and granuloma formation (48.6 %). Surgical removal of the filler material was attempted in four patients. Conclusions With the increased use of dermal fillers and the derived complications, there is a need to determine the optimal treatment for those patients, as a wrong treatment strategy can lead to scarring. This study suggests general recommendations for the referral and treatment of patients with more severe complications associated with dermal filler injection. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2016-06-28
       
  • Blood supply to the second metatarsophalangeal joint—anatomical
           injection study and clinical correlation for free vascularised joint
           transfer
    • Abstract: Background Reconstruction of the injured/arthritic metacarpophalangeal joint remains challenging. Free vascularised joint transfer (VJT) using the second metatarsophalangeal joint (MTPJ) remains the gold standard, with an oblique osteotomy is usually performed to correct the natural hyperextended MTPJ during transfer. Surprisingly, few descriptions of the MTPJ arterial supply exist, despite reports of avascular necrosis of the MTP head following VJT. This study provides an up-to-date investigation of the second MTPJ blood supply. Methods The anterior and posterior tibial arteries in three cadaveric feet were injected with an Indian ink-latex mass. The second toe was dissected in its entirety. A modified Spalteholz technique was then used to demonstrate the extraosseus and intraosseus blood supply of the metatarsal head. Results Irrespective of arterial dominance within the first web space, the MT head was observed to receive a constant branch from the first dorsal metatarsal artery (FDMA) at a mean distance of 2.1 cm from the MTPJ. Variable articular branches were also observed to branch from the first/second plantar metatarsal arteries. Conclusions This is the first formal injection study to identify the presence of a constant articular branch from the FDMA. During VJT dissection, better knowledge of the blood supply allows planning of osteotomy without compromising blood supply to the MT head. Level of Evidence: Not ratable.
      PubDate: 2016-06-24
       
  • Wrap technique to cover exposed Achilles tendon with the soleus muscle
    • Abstract: Abstract Numerous etiologies may lead to loss of Achilles tendon coverage. Currently, multiple coverage options are available to the reconstructive surgeon; however, described techniques may not meet every patient’s need. In this case report, we describe the use of a simple technique, utilizing the soleus to cover exposed Achilles by folding the muscle circumferentially around the tendon. The technique described is a local option, creates minimum morbidity, does not require microsurgical skills, and can be performed quickly. Level of Evidence: Level V, therapeutic study.
      PubDate: 2016-06-15
       
  • Negative pressure wound therapy induces early wound healing by increased
           and accelerated expression of vascular endothelial growth factor receptors
           
    • Abstract: Background Negative pressure wound therapy (NPWT) is commonly used to accelerate wound healing, especially following thoracic surgery; however, the mechanism remains elusive. Given the important role of vasculogenesis in wound healing, we evaluated whether NPWT might accelerate vasculogenesis in the wound area. Toward this end, we investigated the temporal expression of vascular endothelial growth factor receptors (VEGFRs) in an NPWT-wound healing rabbit model. Methods Rabbits were divided into an NPWT group and a non-NPWT control group, and tissue samples were collected around wounds made in the skin of each rabbit at five time points: 0, 7, 14, 21, and 28 days after wound creation. Cryopreserved samples were then immunostained and subject to image analysis to evaluate the temporal changes in VEGFR1, VEGFR2, and VEGFR3 expression in the wound-healing process. Results Results of histological analysis of the temporal changes in VEGFR expression throughout the healing process showed that compared to the control group, VEGFR2 and VEGFR3 were abundantly and rapidly expressed in the NPWT group, and were expressed earlier than VEGFR1. Conclusions NPWT promotes the expression of VEGFR2 and VEGFR3, which provides insight into the mechanism by which NPWT accelerates wound healing. Level of Evidence: Not ratable.
      PubDate: 2016-06-13
       
  • Median poststernotomy dehiscence reconstruction—a new classification
           for selection of the best procedure
    • PubDate: 2016-06-07
       
  • The fully rotated tensor fasciae latae perforator propeller flap in
           reconstruction of trochanteric pressure sores
    • Abstract: Abstract Reconstruction of trochanteric pressure sores continues to challenge reconstructive surgeons because recurrence is not uncommon and patients typically have undergone previous surgery. We herein report on the use of a large adipocutaneous TFLPP rotated for 180° facilitating reconstruction of a recurring trochanteric decubital ulcer in a 37-year-old male morbidly obese patient with diabetes mellitus. The postoperative period showed no adverse events, and no recurrence was observed to date. The TFLPP is a valuable option because skin grafts are usually not needed for donor-site closure, the muscle is spared, and minimal donor-site morbidity as well as a less bulky appearance is observed. Level of evidence: Level V, therapeutic study.
      PubDate: 2016-06-06
       
  • An original technique for the correction of congenital inverted conchal
           bowl deformity in an adult
    • Abstract: Abstract Common congenital deformities of the ear include varying degrees of prominent ears and of microtia. Inverted conchal bowl is a very rare congenital deformity. In this condition, the anterior concavity of the concha is replaced by convexity, resulting in an abnormal appearance, as well as functional problems in the of use earpiece devices. This condition has been reported only once in a series of four paediatric cases, wherein a cartilage scoring technique, suitable for pliable cartilage in that age group, is described. No cases have been reported in an adult. We describe a simple and effective technique of managing this rare deformity in an adult, for the first time. The principle of the technique is the use an autologous cartilage graft. Level of Evidence: Level V, therapeutic study.
      PubDate: 2016-06-06
       
  • Human fetal wound healing: a review of molecular and cellular aspects
    • Abstract: Abstract The physiological answer to after birth skin lesions is scarring, which compromises the function and the aesthetics of the injured area. However, fetuses in early gestation (24 weeks or less) respond to this damage with skin regeneration. To explain this difference, several factors are considered, such as increased production of collagen III in fetal fibroblasts and increased presence of this collagen in the skins of these fetuses. Increased hyaluronic acid in fetal matrix correlates with greater capacity for migration of fibroblasts in scarless repair. The fact that myofibroblasts in the wound appear only after the fetal stage of pregnancy which forms scars can also be correlated. Additionally, there is an increase in the amount of adhesion molecules in repair without scarring, which would multiply cell adhesion and migration. Lower levels of bTGF1 in fetal wound are correlated with reduced amounts of collagen I and may be the result of higher relative expression of bTGF3, which downregulates bTGF1. Amniotic fluid itself might be a stimulating factor to human skin’s fibroblasts proliferation through cytokines such as bFGF and PDGF. A hypoxic environment in the fetal wound, associated with increased presence of Dot cells in blood, is also observed, and both facts can be related to a difference in the repair of the skin. Distinct gene expression guides those different responses and may also help to elucidate fetal skin regeneration. When the mechanisms responsible for the absence of scars in wounded fetuses are enlightened, it will be a significant mark in the studies of wound cicatrization and its therapeutic applications shall be extremely valuable. Level of evidence: Not ratable.
      PubDate: 2016-06-02
       
  • Ten years of acute hand trauma: is day case surgery still working' A
           review of 726 patients
    • Abstract: Background Day surgery units (DSUs) have streamlined the treatment of hand trauma. This study describes how the establishment of the Birmingham Hand DSU has improved the service over a 10-year period. Methods Data was collected on patients requiring surgery for acute hand trauma for a period of 1 month at four separate time points: (1) prior to establishment of DSU, (2) 1 month following DSU opening, (3) 1 year following DSU opening and (4) 8 years following DSU opening. The number and types of operation performed, day case rates, and bed occupancy rates were analysed. Statistical analysis was performed using Fisher’s exact test. Results The volume of hand trauma has increased over time (77 cases/month-2002; 109-2003; 90-2004; av. 150-2011). Sharp lacerations and crush injuries remain the most common. The percentage of patients admitted has fallen (84.4% 2002; 64.2% 2003; 46.7% 2004; 33.6% 2011 p = 0.0003) whilst the day case rate has increased (13.0% 2002; 33.9% 2003; 51.1% 2004; 67.5% 2011 p = 0.004). Bed occupancy rate per patient has fallen (2.64 days-2002; 2.08-2003; 1.34-2004; 1.21-2011). Conclusions Despite an increased caseload, increased utilisation of the DSU has led to reduced patient waiting times and bed occupancy rates whilst increasing patient satisfaction and reducing costs. Level of Evidence: Level III, risk/prognostic study.
      PubDate: 2016-06-01
       
  • Improving the reliability of the Keystone flap
    • PubDate: 2016-06-01
       
  • Management of androgenetic alopecia: a comparative clinical study between
           plasma rich in growth factors and topical minoxidil
    • Abstract: Background Androgenetic alopecia (AGA) is a common hair disorder. Finasteride and minoxidil have been approved by the Food and Drug Administration (FDA) for the treatment of AGA. However, some side effects have been related to the intake of these drugs. Recently, plasma rich in growth factors has emerged as a safe alternative for the management of pattern hair loss. The purposes of the present study are to evaluate and compare the efficacy and safety of plasma rich in growth factors (PRGFs) versus topical minoxidil treatment in AGA-affected patients. Methods Following a retrospective case control design, 379 patients treated with either PRGF or minoxidil were included in this study. Diagnostic trichograms at baseline and 4 months after treatment were performed with the aim of analyzing the anagen/telogen hair change improvement. Results PRGF-treated patients showed higher anagen hair increase improvement compared to minoxidil-treated ones (6.9 ± 0.4 and 4.6 ± 0.5 %, respectively) (p < 0.05). Telogen hair decrease improvement was also higher in PRGF group (5.7 ± 0.3 and 2.6 ± 0.5 %, respectively) (p < 0.05). Global photographs showed an overall volume and quality hair improvement for both treatments. No adverse effects were reported. Conclusions This retrospective study shows that PRGF is a safe and effective treatment for AGA and evidences that PRGF exerts improved anagen/telogen results than topical minoxidil. Level of evidence: Level IV, therapeutic study.
      PubDate: 2016-06-01
       
 
 
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