George Rahmani

Fat Grafting: A Citation Analysis of the Seminal Articles

Background: There has been substantial rise in the volume of published works on fat transfer in the medical literature in the past 25 years, and this is indicative of its growing popularity. However, many unanswered questions remain, and there is no consensus as to the optimum technique. Consequently, the scientific and clinical research on fat grafting continues to increase rapidly. The purpose of our study was to perform a bibliometric analysis of the most-cited articles in fat transfer. Methods: Through the Web of Science, all articles relating to fat grafting were identified in the plastic and reconstructive literature. The 100 most-cited articles were identified and analyzed individually. Results: Total citations ranged from 35 to 363 and the most-cited paper by Sidney Coleman was published in Plastic and Reconstructive Surgery. The United States produced 46% of the most-cited papers, and the University of California was the most prolific institution. Twenty-one articles focused on lipofilling to the face while 14 articles looked at fat grafting to the breast. Conclusions: The scientific relevance of a published work is reflected in the number of citations from peers that it receives. Therefore, the 100 most-cited papers in fat grafting have been the most influential articles on this field, and they are likely to be the ones that are remembered most.

Gena Norris and gadolinium deposition disease-the impact of celebrity health disclosure on public awareness

This year marks the 30 anniversary since the approval of gadolinium-based contrast agents (GBCAs) for diagnostic use in MRI. To date, well over 300 million doses of GBCAs have been administered to patients and have repeatedly been shown to be safe for use. However, a recent high profile celebrity case of what is being colloquially termed “gadolinium poisoning” has thrust the safety profile of GBCAs into the media spotlight and patient awareness. Gena Norris, wife of retired Hollywood actor and mixed martial artist Chuck Norris, spoke candidly in an interview with CBS news on November 2, 2017 about the symptoms she developed following a contrast-enhanced MRI performed over 5 years ago. Both she and her husband have been vocal about GBCAs and addressed the Food and Drug Administration (FDA) in an open letter that was read out before the FDA’s vote on gadolinium warning labels in September 2017. We would like to take this opportunity to extend our sympathy and support to Mrs. Norris, who, as a patient has undoubtedly experienced distressing symptoms. Previously, high profile celebrity cases have increased the public’s awareness of certain health issues. This was most famously demonstrated by what has been dubbed as the “The Angelina Effect” by Time magazine. Hollywood actress, Angelina Jolie, underwent a bilateral prophylactic mastectomy and eventual completion oophorectomy after discovering that she was positive for the BRCA1 gene. A paper published in 2014 found that public demand for BRCA gene testing almost doubled as a result. We aimed to ascertain whether the Gena Norris case had an effect on the public’s awareness of GBCAs and gadolinium retention by examining recent trends in internet searches. The software Google Trends (Google, Inc.) was used to examine internet trends over the past 5 years for the search terms “gadolinium,” “gadolinium deposition disease,” and the more colloquial term, “gadolinium poisoning.” Google trends provide information on the relative popularity of an internet search term over time. A score of 100 indicates the peak popularity for that search term over the time period selected by the user. A score of 50 indicates a relative popularity equating to 50% of the value for the most popular time for that particular search term. Google trends from January 2013 to January 2018 were examined. The peak popularity for the search terms “gadolinium poisoning” and “gadolinium deposition disease” occurred over the week of October 29–November 4, 2017 (Figure 1). This was the week of the Gena and Chuck Norris interview with CBS about gadolinium agents. The peak popularity for the term “gadolinium” was over the week of November 5–11, 2017, the week after the aforementioned interview, by which time it had been reported on by media outlets worldwide (Figure 1). High profile celebrity health disclosures can cause significant increases in the public health awareness of disease. It is

The “Christmas notch”: a novel use for the punch biopsy blade

he punch biopsy blade consists of a hollow circular blade at the end of a pencil-like handle. It is an instrument often T found in the armamentarium of your friendly neighbourhood dermatologist. It was first developed by Keyes in 1887, and has since been described as having diagnostic, therapeutic and cosmetic uses. The sharp, circular blade allows the clinician to take a small, predetermined piece of tissue (ranging from 0.5 to 10 mm), which can subsequently be sent for histopathological analysis. The authors have discovered that the unique shape of the punch biopsy blade also makes it a useful tool for cutting a new notch in a leather belt.

The Use of Mobile Apps by Radiology Journals

Dear Editor, Mobile applications (apps) have grown exponentially in number since they were first introduced in 2008. There are now over 2.2 million apps on Apple’s iOS platform. Academic journals often use apps to provide another platform for their readers and subscribers to easily access their content. We aimed to determine whether radiology journals have adopted apps and whether those journals with apps have a higher impact factor than those without. The journals listed in the Institute of Science Information Web of Science subject category Bradiology, nuclear medicine, and medical imaging^ were searched in the Apple® App StoreTM. The journal name, category, impact factor, and publisher were recorded. A total of 112 radiology, nuclear medicine, and medical imaging journals were identified, with 4 being excluded as they are no longer actively publishing. Of the remaining 108 journals, 20 (18.5%) of journals had a dedicated app for their subscribers to view the content of their journal directly (Table 1). These journals had a higher mean impact factor when compared with those journals that did not have a dedicated app (2.859 vs. 2.103; p = 0.031). The publishing company with the most journals providing dedicated apps for their readers was Springer (n = 8). Of the 108 identified radiology journals, 20 have a dedicated mobile app to allow readers another avenue to access the journal content. These journals appear to have a higher impact factor. It may be that journals with higher impact factors have more resources at their disposal and have invested in developing and maintaining their own app. It is also possible that these journals have a wider readership because of their apps, which in turn could eventually lead tomore citations and higher impact factors. Almost one fifth of radiology journals provide a dedicated mobile app to allow ready access to the journal’s content for their readers and subscribers. These journals have an overall higher impact factor compared with radiology journals without a dedicated mobile app. We feel that radiology journals and their publishers should be encouraged to design and maintain mobile apps for their readers.

Radiology Toolbox Pro App Review

App Name: Radiology Toolbox Pro App Icon URL: https://itunes.apple.com/us/app/ radiology-toolbox-pro/id466281848?mt=8 App Developer: Eric M. Baumel, MD and Softcode Systems, Inc. App Developer Website: https://www.softcode.com/ App Price:

The diagnostic accuracy of ultrasonography for soft tissue lipomas: a systematic review:

3.99 for Pro version. A free BLite^ version also exists Apple App Store URL: https://itunes.apple.com/us/ app/radiology-toolbox-pro/id466281848?mt=8 Google Play Store URL: Currently only available on iOS Category: learning, radiological guidelines, calculator Tags: radiology, iPad-compatible, guidelines Works Offline: Yes FDA Approval: N/A Quick Review (1 star, lowest; 5 stars, highest) Overall Rating (1–5): 4 Content (1–5): 4 Usability (1–5): 5 Pros: Easy access to useful and frequently called upon information. Simple menu with nice graphics. Cons: Currently only available on iOS. At a glance: This app provides easy access to information that most radiologists find themselves looking up several times throughout the day. It includes calculators, anatomy diagrams, diagnostic guidelines, followup guidelines and contrast dye information

The sharing of radiological images by professional mixed martial arts fighters on social media

Background Ultrasound has been used in the diagnosis of soft-tissue lesions for well over a decade. Lipomas are the most common, benign, soft-tissue tumor and comprise adipose tissue. The sensitivity and specificity of diagnosing lipomas on ultrasound vary greatly in the literature. Purpose To perform a systematic review on ultrasonography in soft-tissue lipomas to better ascertain the true diagnostic value of this test. Material and Methods A systematic review of the diagnostic value of ultrasound in lipomas was performed where possible in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search of the literature was conducted using several well-known databases Scopus®, PubMed®, Ovid® Medline, and Web of Science®. Results A total of 455 articles were identified in the initial literature search. Six papers were included in the final systematic review, which revealed an overall sensitivity and specificity of 86.87% (95% confidence interval [CI] = 82.14–90.73) and 95.95% (95% CI = 93.75–97.54), respectively. Conclusion Ultrasound is a useful tool in the diagnosis of superficial lipomas with good sensitivity and even better specificity and should continue to be the first line investigation in such cases.

A quick and easy makeshift suture pad

Background Mixed martial arts is a sport that has recently enjoyed a significant increase in popularity. This rise in popularity has catapulted many of these “cage fighters” into stardom and many regularly use social media to reach out to their fans. An interesting result of this interaction on social media is that athletes are sharing images of their radiological examinations when they sustain an injury. Purpose To review instances where mixed martial arts fighters shared images of their radiological examinations on social media and in what context they were shared. Material and Methods An Internet search was performed using the Google search engine. Search terms included “MMA,” “mixed martial arts,” “injury,” “scan,” “X-ray,” “fracture,” and “break.” Articles which discussed injuries to MMA fighters were examined and those in which the fighter themselves shared a radiological image of their injury on social media were identified. Results During our search, we identified 20 MMA fighters that had shared radiological images of their injuries on social media. There were 15 different types of injury, with a fracture of the mid-shaft of the ulna being the most common. The most popular social media platform was Twitter. The most common imaging modality X-ray (71%). The majority of injuries were sustained during competition (81%) and 35% of these fights resulted in a win for the fighter. Conclusion Professional mixed martial artists are sharing radiological images of their injuries on social media. This may be in an attempt to connect with fans and raise their profile among other fighters.

Dupuytren's Contracture: A Bibliometric Study of the Most Cited Papers

nerve blocks by anaesthesiologists. Currently, understanding of anatomy revealed during ultrasound (US) scanning is arguably more important, because anaesthesiologists use this technology to discern anatomy at the bedside and guide needle placement. The best way to teach and reinforce this ‘sono-anatomy’ to anaesthesiology residents, who have previously undergone training in gross anatomy in medical school, is uncertain. A variety of instructional tools, including cadaver dissection, pro-sected cadavers and on-line teaching aids, may be utilised to review relevant anatomy for residents learning peripheral nerve blockade. Computerised dissection programmes (CDP) represent one such tool and have been shown to improve the understanding of human morphology and structural relationships. However, their potential utility in improving understanding of two-dimensional ultrasound depictions of anatomy is uncertain. What was tried? We evaluated the usefulness of a CDP as an aid to anaesthesiology residents to identify sono-anatomy structures that they failed to identify correctly on an exam. Ten senior residents who had previously undergone peripheral nerve blockade training were introduced to the CDP (MeAV Anatomie 3D-Multiview Anatomy System; Panasonic Corporation, Osaka, Japan), which permits layer-bylayer observation of dissected anatomy for 32 different regions of the body. Functionally, the system permits three-dimensional viewing, rotation and zooming in for each dissected region. The residents then participated in a 20-question assessment exam, in which they were required to identify five relevant structures on US images from the anatomical site of four commonly performed peripheral nerve blocks. For each region, the resident was immediately informed of incorrect answers and asked to try to correct the answer by using the CDP. Three minutes were allotted for this remediation for each anatomical site. We then asked them to provide their impressions of both the usefulness of the computerised dissection system to answer anatomy questions and the ease of use of the system for the operator. What lessons were learned? On the examination, residents’ retention of knowledge of structures surrounding the nerves, as depicted on ultrasound, was relatively poor, ranging from 36% to 66% correct. However, utilising the CDP, the residents were able to identify and correct, on average, 68% of their incorrect answers. The participants provided favourable feedback about the use of the CDP for on-the-spot refreshment of anatomy knowledge. They rated its functionality highly and saw value in the opportunity to immediately compare three-dimensional anatomy on the computer with two-dimensional US images. These data resulted in a change in our approach to anatomy training in regional anaesthesia for the residents. We now routinely incorporate the CDP when introducing the residents to sono-anatomy. After reviewing relevant structures with the dissection programme for each nerve block, they immediately scan that area with US in a live model to correlate the actual anatomy with the US images.

First Safety and Performance Evaluation of T45K, a Self-Assembling Peptide Barrier Hemostatic Device, After Skin Lesion Excision

The literature on Dupuytrens contracture is vast yet little information is known as to which papers have been the most influential. The purpose of this study was to identify the 50 most cited papers on Dupuytrens contracture and perform a citation analysis. Utilizing the Web of Science, 23 surgical, medical, plastic and hand surgery journals were searched for papers on Dupuytrens contracture. Resulting articles were ranked in order of times cited and each paper was analyzed for article-type, year of publication, country of origin, institution and level of evidence. The 50 most cited articles represent many important landmarks in Dupuytrens treatment and contain several seminal works by experts in the field. Whilst the top 50 list highlights the important papers on the condition, they certainly do not provide information about the quality of the evidence of the research, as most papers presented level 4 or 5 evidence.