Breast augmentation and reconstruction utilizing implants are among the most common plastic surgery procedures performed in the United States. A small proportion of these implants are removed each year. We report 2 cases where routine pathologic evaluation of capsulectomy specimens revealed squamous cell carcinoma associated with the breast implant capsule and discuss the possible pathogenesis of this unusual entity. Both patients had long-standing implants (>10 years) and presented with acute unilateral breast erythema and swelling. Intraoperatively, the capsules for both cases appeared thickened and calcified, containing extensive granulomatosis and keratinaceous debris invading into the chest wall. Extensive workup failed to find an occult primary. One patient died from a malignant pleural effusion secondary to tumor invasion during chemotherapy, and the second patient obtained stabilization of the mass after 5 weeks of chemotherapy but subsequently declined further surgical intervention. A thorough lhis entity may allow for earlier suspicion, diagnosis, and management.

Patients with factitious disorder (FD) or “Munchausen syndrome” intentionally fabricate or induce medical problems for psychological gratification. They may deceive plastic surgeons into performing multiple unnecessary procedures. OTX008 undertook the first systematic review of FD case reports in plastic surgery. Our aims were 2-fold (1) describe the adverse outcomes associated with these cases and (2) identify strategies for their prevention by surgeons.

MEDLINE, EMBASE, and SCOPUS databases were searched. We included cases in which an adult with FD presented to a plastic surgeon. Our search returned a total of 42 eligible cases reported from North America (43%), Europe (37%), and Asia (20%).

Seventy-six percent of patients were women, and 62% worked in health care. Sixty percent had a comorbid psychiatric disorder, the most common (50%) being depression. Ninety-three percent of our sample presented with self-induced lesions. The average delay in diagnosis of FD was 54 months, with 46% of patients receivin use and negative investigations. Finally, plastic surgeons may play an important role in managing such patients. Management strategies include direct observation by nursing staff in the postoperative period and use of strict occlusive dressings to prevent access to surgical wounds.

Patients with FD who present to plastic surgeons are high risk the majority require surgical intervention for severe self-injury, and many engage in harmful behaviors, such as “doctor-shopping.” Early recognition of FD in plastic surgery is, therefore, crucial and may be achieved via careful examination of lesions for unusual morphology. Medical records may reveal extensive health care service use and negative investigations. Finally, plastic surgeons may play an important role in managing such patients. Management strategies include direct observation by nursing staff in the postoperative period and use of strict occlusive dressings to prevent access to surgical wounds.The reverse medial plantar flap (RMPF) raised from the nonweight-bearing region of the plantar foot represents a viable option for the soft tissue defect in planter forefoot. The anatomical basis of RMPF is the complex anastomotic branches between medial plantar artery (MPA) and deep plantar arch. Those anastomotic branches have high variation rate and may be damaged by trauma such as electric injury. #link# Therefore, it is very important to know whether those anastomotic branches are present and intact before harvesting RMPF. Five patients with soft tissue defect in planter forefoot were enrolled into the study. The digital subtraction angiography (DSA) was performed to evaluate the plantar hemodynamics in the ipsilateral foot. The RMPF was harvested only after the anastomotic connections between MPA and deep plantar arch was confirmed. Anastomosis between superficial branch of MPA and deep plantar arch was observed in all DSA examinations. All 5 patients received the repair of soft tissue defect in plantar forefoot with RMPF. All flaps survived completely. The DSA can effectively evaluate the blood supply basis of RMPF and provide imaging evidence for the design and harvest of the flap. The main anatomical basis of RMPF is the anastomotic connections between superficial branch of MPA and deep plantar arch.SARS-CoV-2 is a novel and highly contagious coronavirus that has been a major threat to the public’s health. As the pandemic has spread across the United States, it has become abundantly clear that vulnerable populations include not only the elderly and individuals with disabilities but also those who are homeless or incarcerated, Latinx Americans, African Americans, and Native Americans. This report is focused on the experience of Black patients, inclusive of African Americans, and recognizes the higher morbidity and mortality in this population. Physiatrists can provide care for the sequelae faced by survivors and prioritize rehabilitation services. Programs must be administered in a way that is geographically accessible to Black communities and demonstrate cultural competence. Future research should focus on the social determinants of health to better understand at-risk populations and improve outcomes.Individuals with stroke often experience contralesional and ipsilesional arm motor deficits.

Compare fine and gross motor hand dexterity of the ipsilesional hand post-stroke with controls, normative values, and the contralesional hand.

Data were collected from right-handed individuals with chronic stroke (n = 20), age/sex matched controls (n = 10), and normative values (n = 20) performing the Nine Hole Peg Test and the Box and Blocks Test.

Individuals with stroke demonstrated poorer performance with the ipsilesional arm relative to both the control group (mean difference [95% CI] Nine Hole Peg Test (s) 3.4 [-0.5, 7.3]; Box and Blocks Test (# blocks) -12.3 [-20.3, -4.2]) and normative values (mean difference [95% CI] Nine Hole Peg Test (s) 6.5 [4.0, 9.1]; Box and Blocks Test (# blocks) -15.3 [-20.1, -10.5]). Ipsilesional arm performance was significantly better than performance with the contralesional arm (mean difference [95% CI] Nine Hole Peg Test (s) -9.4 [-20.2, 1.4]; Box and Blocks Test (# blocks) 33.