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Copyright of European Surgery: ACA Acta Chirurgica Austriaca is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cognitive impairments associated with schizophrenia (CIAS) represent a central element of the symptomatology of this severe mental disorder. CIAS substantially determine the disease prognosis and hardly, if at all, respond to treatment with currently available antipsychotics. Remarkably, all drugs presently approved for the treatment of schizophrenia are, to varying degrees, dopamine D2/D3 receptor blockers. In turn, rapidly growing evidence suggests the immense significance of systems other than the dopaminergic system in the genesis of CIAS. Accordingly, current efforts addressing the unmet needs of patients with schizophrenia are primarily based on interventions in other non-dopaminergic systems. In this review article, we provide a brief overview of the available evidence on the importance of specific systems in the development of CIAS. In addition, we describe the promising targets for the development of new drugs that have been used so far. In doing so, we present the most important candidates that have been investigated in the field of the specific systems in recent years and present a summary of the results available at the time of drafting this review (May 2022), as well as the currently ongoing studies. [ABSTRACT FROM AUTHOR]

Background: Patients who undergo Roux-en-Y gastric bypass (RYGB) have significant weight loss, and abdominoplasty is an effective corrective surgery for removing excess skin. This study aimed to evaluate the impact of the weight of removed tissue on the development of postoperative complications in patients undergoing abdominoplasty without lipoaspiration after gastric bypass at the Federal District North Wing Regional Hospital, Brasília, Brazil. Methods: Data were analyzed from a prospective registry of patients who underwent abdominoplasty without lipoaspiration after gastric bypass from January 2011 to December 2018. The variables examined included body mass index (BMI) before RYGB and before plastic surgery, weight loss, weight of the excised abdominal flap, comorbidities, and medical complications. Analysis of the role of the weight of the removed tissue after abdominoplasty was performed to assess outcome measures. Results: One hundred sixty-three patients were included. The mean age of the patients was 42 years. Their BMI at the time of abdominoplasty was 27.49 kg/m2, and the average weight loss before abdominoplasty was 47.13 kg. The preweight loss BMI was 45.27 kg/m2, and the ∆BMI was 17.78 kg/m2. The overall complication rate was 29.4%. An amount of removed tissue from the abdomen ≥ 2000 g significantly increased the rates of postoperative complications (46.7% vs. 19.4%; p = 0.002; OR = 3.13). Conclusions: Removal of ≥ 2000 g of tissue from the abdomen led to significantly more complications in patients who underwent abdominoplasty after gastric bypass. In addition, this group of patients was significantly associated with the presence of higher anthropometric variable values (BMI, weight loss, max BMI, and ∆BMI) and not associated with the presence of comorbidities. [ABSTRACT FROM AUTHOR]

Introduction: Recent years have seen an increased utilisation of upper body lift following massive weight loss. Although it is typically considered cosmetic, the recurrent skin conditions and decline in quality of life may warrant medical necessity. We evaluated current insurance coverage and characterised policy criteria for upper body lift in the post-bariatric population. Methods: We defined upper body lift as a combination of mastopexy and upper back excision (UBE) and conducted a cross-sectional analysis of US insurance policies. Insurance companies were selected based on their enrolment data and market share. A web-based search and telephone interviews were conducted to identify the policy. Criteria were abstracted from the publicly available policies that offered coverage. Results: Of the 56 insurance companies assessed, 5% would consider coverage of both procedures. Although fewer companies held established policies for UBE than mastopexy in the post-bariatric population (79% vs 96%, p = 0.0081), there were significantly more policies that offered pre-approval for UBE than for mastopexy (30% vs 5%, p = 0.0017). Three medical necessity criteria were common to both procedures: evidence of functional impairment, secondary skin conditions, and medical photographs. Conclusion: Policy criteria for coverage of mastopexy or UBE differ greatly between companies. Further evaluation of medical necessity criteria for post-bariatric mastopexy and UBE with the establishment of a standardised guideline is needed. We propose a comprehensive list of reporting recommendations to help optimise authorisation of upper body lift in the post-bariatric population, and we urge plastic surgeons to challenge current definition of "cosmetic" by insurance companies. Level of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Purpose: Estimation and comparison of results after incisional hernia repair (IHR) modo onlay or sublay with abdominoplasty in patients who lost the weight following Roux-en-Y Gastric Bypass (RYGB). Analysis and comparison of changes in quality of life (QL) of these patients prior to RYGB, before and after simultaneous IHR and abdominoplasty.Methods: Clinical analysis involved 40 patients with abdominal disfigurement (following RYGB and massive weight loss) after one-time IHR sublay method with abdominoplasty-group 1 or IHR onlay method with abdominoplasty-group 2. We evaluated postoperative results and long-term QL changes (DAS24, SF-36 scales).Results: We noted abnormal wound healing (2), pneumonia (3) and dysesthesia (3) in patients from group 1, and abnormal wound healing (2), seroma (2), pneumonia (2), and dysesthesia (4) in group 2. Quality of life was improved in the functional, esthetic and psychological aspects.Conclusions: One stage incisional hernia repair by onlay as well as sublay method with abdominoplasty are safe surgical methods improving the functioning of patients after major weight loss following RYGB. Sublay hernia repair and abdominoplasty was connected with longer time of the: operation, drainage, analgesic agents use, time to mobilization and to full oral diet than the onlay method. Significant improvement of the quality of life was noted after every subsequent step of surgical treatment in both groups. Reduction of the risk of BMI re-growth after bariatric surgery is related to the need for constant, specialized care for these patients at every stage of follow-up after bariatric surgery. [ABSTRACT FROM AUTHOR]

Background: The use of injectable solutions for aesthetic purposes has increased tremendously, but lacks objective support. We aimed at assessing static and dynamic effects of botulinum toxin A (BoNTA) on glabellar lines by use of an objective three-dimensional methodology.Methods: We prospectively collected three-dimensional stereographic photographs of two different facial expressions (pretreatment, 30 and 90 days posttreatment) in 21 patients, receiving a total of 20 units of BoNTA in both corrugator supercilii muscles. The primary endpoint was the three-dimensional static and dynamic surface irregularity, and secondary endpoints were the glabellar line scale and overall patient satisfaction. Blinded retrospective data analysis and statistical evaluation were performed with p < 0.05 considered statistically significant.Results: Static glabellar lines (neutral facial expression) were significantly reduced by − 17% and − 24% on day 30 and 90 posttreatment, respectively (vs. pretreatment; both p < 0.0001). Dynamic glabellar frown lines (firmest possible bilateral eye closure) demonstrated a reduction of surface irregularity by − 26% and − 21% on day 30 and 90 posttreatment, respectively (vs. pretreatment; both p < 0.0001). The subjective dynamic glabellar line scale documented a statistically significant improvement on day 30 posttreatment (mean ± SD: 1.5 ± 0.8; p < 0.05) versus pretreatment (2.8 ± 1.0). Polled patients confirmed a subjective wrinkle improvement 90 days posttreatment.Conclusion: The presented setup detected even subtle changes of BoNTA treatment for facial wrinkling and is a promising asset for scientific evaluations of clinical studies analyzing the outcome and duration of efficacy of injectable solutions on the face.Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Background: In Canada, one year after bariatric surgery follow-up appointments become less frequent and surgical recipients must cope with weight management more independently. Up to 50% of patients experience weight regain by two years post-surgery. Understanding the lived experiences of those who have gone through the bariatric process may shed light on what is needed to support others moving forward. Therefore, the purpose of the study was to gain an understanding of the physical, psychological, social, and clinic-related experiences of individuals who have undergone bariatric surgery at least two years prior.Purpose: The purpose of the study was to gain an understanding of the physical, psychological, social, and clinic-related experiences of individuals who have undergone bariatric surgery at least two years prior.Methods: In-depth, individual semi-structured interviews lasting approximately 60 min were conducted. Interviews were transcribed verbatim and inductive content analysis was used to identify emerging themes. Methods were employed throughout to support data trustworthiness.Results: Participants (n = 28; 21 female) were primarily middle-aged (mean: 49.7 ± 12.7 years old), Caucasian (71%), and completed bariatric surgery more than three years. The data fell naturally into four primary themes, namely physical changes and challenges, psychological experiences, social functioning and support, and clinic-related experiences and reflections.Conclusions: Generally, participants described positive improvements in their physical, psychological, and social state since surgery. However, concerns pertaining to several unanticipated outcomes of the surgery were underscored and informed the recommendations for other patients to be prepared to relearn about ones' body, utilize the support services available, and be aware that social relationships may change and/or require tending. Participants' insights can be used to help others meet with long-term success post-bariatric surgery. [ABSTRACT FROM AUTHOR]

The article presents abstracts on medical topics which include psychological factors associated with anterior cruciate reconstruction, factors that affect anterior cruciate ligament-reconstruction (ACL-R), and preoperative surgical planning in the arthroscopic Latarjet procedure.

Testosterone is an androgenic steroid hormone, which plays an important role in the regulation of male reproduction and behaviors, as well as in the maintenance of insulin sensitivity. Several studies showed that testosterone exerted beneficial effects in brain function, including preventing neuronal cell death, balancing brain oxidative stress and antioxidant activity, improving synaptic plasticity and involving cognitive formation. Although previous studies showed that testosterone deficiency is positively correlated with cognitive impairment and insulin-resistant obesity, several studies demonstrated contradictory findings. Thus, this review comprehensively summarizes the current evidence from in vitro, in vivo and clinical studies of the relationship between testosterone deficiency and insulin-resistant obesity as well as the correlation between either insulin-resistant obesity or testosterone deficiency and cognitive impairment. Controversial reports and the mechanistic insights regarding the roles of testosterone in insulin-resistant obesity and cognitive function are also presented and discussed. [ABSTRACT FROM AUTHOR]

Background: After bariatric surgery, the majority of patients develop a problem with excessive hanging skin. This can negatively influence the psychological benefits associated with bariatric surgery. The present study aims to explore the relationship between overall impairment related to the presence of excessive skin, body image, depressive symptomatology, sexual functioning, and weight regain in a sample of women after bariatric surgery. Methods: Sixty-one women (body mass index (BMI) = 30.45 ± 5.35 kg/m) with excessive skin who had undergone bariatric surgery 19.02 ± 9.98 months before were evaluated as part of a cross-sectional study using a semi-structured clinical interview and completed a set of self-report measures. A path analysis, an extension of multiple regression analysis, using IBM® SPSS® Amos™ was conducted to explore simultaneously the associations between the variables under study. Results: The model tested with path analysis showed a good fit to the data ( χ = 1.241, df = 4, p = 0.871; Comparative Fit Index (CFI) = 1.000, Tucker-Lewis Index (TLI) = 1.138, Incremental Fit Index (IFI) = 1.049, Root-Mean-Square of Approximation (RMSEA) = 0.000) and suggests that sexual functioning and overall impairment caused by excessive skin were associated with concerns regarding body image and depressive symptomatology, which in turn relate to a greater percentage of total weight regain. Conclusions: These data stress the importance of considering sexual intimacy and body image in order to optimize psychological and weight outcomes after bariatric surgery. [ABSTRACT FROM AUTHOR]

The aim of this article is to explore bodily changes following weight loss surgery. Our empirical material is based on individual interviews with 22 Norwegian women. To further analyze their experiences, we build primarily on the phenomenologist Drew Leder`s distinction between bodily dis-appearance and dys-appearance. Additionally, our analysis is inspired by Simone de Beauvoir, Merleau-Ponty and Julia Kristeva. Although these scholars have not directed their attention to obesity operations, they occupy a prime framework for shedding light on different dimensions of bodily change. In doing so, we were able to identify two main themes: The felt 'inner' body versus the visible 'surface' body and the 'old' body versus the 'new' body. In different, though interconnected ways, these main themes encompass tensions between changes the women experienced as contributing to a more 'normal' and active life, feeling more accepted, and changes that generated ambivalence. In particular, their skin became increasingly problematic because it did not 'shrink' like the rest of the body. On the contrary, it became looser and looser. Moreover, badsmelling folds of skin that wobbled, sweated and chafed at the smallest movement, aprons of fat hanging in front of their stomachs, batwing arms, thick flabby thighs and sagging breasts were described as a huge contrast to the positive response they received to their changed body shape when they were out and about with their clothes on. At the same time, they expressed ambivalence with regards to removing the excess skin by means of plastic surgery. Through their own and other women`s experiences they learned removing the excess skin by means of surgery could be a double-edged sword. By illuminating the experiences of the ones undergoing such changes our article offers new insight in a scholarly debate predominated by medical research documenting the positive outcomes of weight loss surgery. [ABSTRACT FROM AUTHOR]

Copyright of Der Orthopäde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archiv für Psychiatrie und Nervenkrankheiten is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archiv für Psychiatrie und Nervenkrankheiten is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)