Posts Tagged ‘right’

Sequencing Genome Helps Get Target Right Treatments For Cancer Patients

Sequencing Genome Helps Get Target Right Treatments For Cancer Patients
Sequencing a cancer patient’s genome can be a brilliant diagnostic tool because it helps doctors select the best treatment for them, researchers from Washington University School of Medicine in St. Louis wrote in JAMA (Journal of the American Medical Association) – they carried out two studies. The First Study – a 39-year old female patient with AML (acute myeloid leukemia) had her genome …

Read more on Medical News Today

No Chemo right now

No chemo right now

Wide Right: Breast cancer awareness hits home for Bucs’ Hayward

Wide Right: Breast cancer awareness hits home for Bucs’ Hayward
The Wide Right column is usually reserved for off-beat interviews to give you better insight into Tampa Bay Buccaneers players, but we’re taking a break from my norm this week.

Read more on The Tampa Tribune

Breast Implant Surgery: Under or Over? Choosing the Right Plane

Like every other decision about breast implant surgery, the question of whether to place the implant under the muscle or over is the subject of much debate, with confusion and misinformation in every direction.

Suffice it to say that there is no single best method that applies to every patient; the key is to establish priorities based upon individual anatomy, implant type, and several other factors.

First we need to define some terms. When the implant is placed in front of (above) the muscle, that is usually called subglandular, since the breast is a gland. Beneath the breast tissue is a layer of muscle, most of which is the pectoralis major. This muscle is shaped like an oriental fan, with the gathered part attaching to the upper arm bone and the outer edge attaching to the sternum, or breast bone, and the ribs.

Since it is only attached to the chest wall around the edge, there is a potential space beneath it where an implant can be placed. When the implant is below (behind) the pectoral muscle, it may be called subpectoral or submuscular.

The term total submuscular is used when other muscles on the chest wall are raised in order to cover the sections of the implant that the pectoral muscle doesn’t. Specifically these areas are on the outside (lateral) and the lower portion.

Typically, the pectoral muscle covers about the upper two thirds of an implant. There are potential advantages to having total submuscular coverage but no agreement among plastic surgeons as to whether or not it is practical to do this in every case.

Why go under the muscle? There are several reasons why this is the most common approach for breast augmentation. (When implants are used for breast reconstruction, they are almost always placed total submuscular.)

One important long-term consideration is that implants under the muscle seem to interfere less with mammograms. Implants may, however, still obscure some of the breast tissue. In theory, this could mean that an early breast cancer could be missed, or diagnosis delayed until the tumor is larger, though studies have shown no indication that this occurs in clinical practice.

Special mammographic techniques called Eklund views are recommended for women with implants, and having implants does not mean that mammograms should be avoided.

Other benefits of submuscular placement are aesthetic; often times, the implants appear more natural. This is because the transition from the upper chest into the top of the breast is smoother, and the outline of the implant is less visible. This becomes much more important in thin women. The implants may be less apparent to touch when they are under the muscle as well.

Historically, submuscular implants have been shown to be less prone to capsular contracture, which is a thickening and hardening of the natural scar layer that is formed around implants. There are other aspects that are probably more important in capsular contracture, however, so this isn’t usually the deciding factor.

There are of course disadvantages to submuscular placement of breast implants as well, otherwise they would all be placed in that plane. Activity of the muscle, whether with normal use or with athletic activity, can affect the implant in several ways.

Some believe that muscle activity “massages” the implant and that capsular contracture is less likely for that reason; there is little hard evidence to support that theory, however. Muscle activity can also push the implant out of position either during healing or over time.

This can be seen as loss of cleavage, with implants being too far apart, or implants too low, called ‘bottoming out”. These problems can be minimized by certain surgical techniques.

Another related problem is distortion of the breast with flexion of the pectoral muscle. When this occurs it is usually minor and typically the breast has a good shape when the muscle is at rest.

It is in fact normal to some degree. More severe cases can be bothersome however, and correctable completely only by placing the implants above the muscle.

Subglandular augmentation is considered when there is adequate tissue for implant coverage and in cases where there is some sagging of the breast. In this situation, the implant will be too high relative to the rest of the breast if it is under the muscle.

My own opinion is that this is sometimes an inadequate solution to the problem of sagging, called ptosis (the “p” is silent in ptosis). It may even contribute to worsening of the problem in the long term, resulting in what is sometimes called a “rock in a sock” appearance. A better approach may be to do a breast lift at the same time rather than place the implants low.

Athletes, body builders, and others with low body fat have a particular problem with choosing the right plane for implants. When they are subglandular, the implants can look obvious and artificial because the thin fat layer under the skin provides little camouflage, and breast tissue is often minimal as well.

On the other hand, submuscular placement can result in unacceptable breast distortion with activity. There may be no ideal compromise in many of these cases, but there is another option called subfascial (pronounced like fashion). The fascia is a fibrous layer on the outer surface of the muscle, behind the breast.

Although it is fairly thin, less than a sheet of paper sometimes, it is a distinct anatomic layer that can provide at least some additional coverage with the implant above the muscle. The subfascial technique has been very helpful in certain patients.

The final decision should be made after consultation and discussion of all of the factors that need to be considered. These include lifestyle as well as anatomic features.

Decide what is important and ask questions: Is the surgeon familiar with all 3 planes of implant placement? What are the pros and cons of each for your specific concerns? What are the long-term considerations? Good outcomes relate to good information and informed choices.

Choosing the Right Badge Reels for Your Id Cards

Retractable badge reels are one of the most popular choices for displaying id cards. For those of you that aren’t familiar with badge reels they are a small device with a retractable cord, designed so the can be attached to a small object. They are usually worn on a belt or pinned to an article of clothing. Choosing the right badge reels for your ID cards doesn’t have to be overwhelming when you know what your options are.

Retractable badge reels are made from either metal or plastic, and you can choose from a variety of styles. Some even have specialized features, and you can certainly order customized badge reels.

Customized Retractable Badge Reels

Imprinting your company name, slogan, or logo is easy to do, and it’s certainly affordable. You can even incorporate a message. It’s an excellent way to promote your business. You have the same types of options as you do with any other retractable badge reels, but they’re customized for your business.

Round Retractable Badge Reels

You can choose from different types of strap materials and strap lengths. If you need a reel that’s going to stand up a little better, then consider the reinforced badge reels, or the heavy duty badge reels. You can chose from either chrome, or a variety of solid or translucent colored plastic reels. The round retractable badge reels are considered an overall good reel to choose.

Square Badge Reels

You can opt for one of the standard colors, or pick from one of the many different colors that will have your company standing out in the crowd. While everyone else is opting for round badge reels, you can be different and choose a square badge reel. Whether you prefer a solid color or a translucent color you’re covered. You can also choose between slide belt clips, spring clips, or the very popular reinforced reels. Like other reels, these are very affordable and readily available.

Translucent Badge Reels

In recent years the demand for something different in badge reels has increased, so now you can find many different types of round and square translucent reels. The translucent reels are neat because they show the inner working of the badge reels. Why hide the workings of the badge reels? It’s different, and it’s definitely a conversation piece. Choose from a swivel back, spring clip, slide belt clip or sticker face. All are readily available. What does this mean to you? It means you can get your badge reel needs met and have something a little different too.

Chrome Badge Reels

Turn up the class on your badge reels by choosing chrome badge reels that shine like a fine piece of jewelry. A chrome finish adds a touch of class solid colors simply can’t achieve. Best of all you can choose from a variety of different badge reel types.

Heavy Duty Badge Reels

Sometimes you need more than average can deliver. Sometimes you need a badge reel that can take a beating, and hold up against heavier loads. The heavy duty badge reels utilize chain or wire rather than a nylon cord. They provide strength and durability you can rely on.

Reinforced Badge Reels

In most badge reels they use a vinyl strap clip to attach the ID card to the reel. With the reinforced badge reel it is given additional strength simply by using a different thread pattern, which strengthens the vinyl and increases the durability. When a standard reel isn’t enough, but a heavy duty is more than you need, the reinforced badge reels are just what you need. For just pennies more you can have the reinforced reels if that’s what you need.

Swivel Badge Reels

There are situations where using a standard badge reel won’t provide you with the necessary flexibility in movement. A swivel back will allow the reel to rotate when you pull on your ID card, which stops the reel from falling off if you pull the clip in the opposite direction.

Smart Badge Reels

A smart reel is a lot like a tape measure. It will retract automatically but you are also able to lock the cord at any length you like. Press the button and the cord will release and retract. It’s one of the handiest badge reels available.

Lanyard Badge Reels

Sometimes it’s necessary to be able to attach a badge reel to a belt, but that’s not always possible. The next best thing is a lanyard, which you wear around your neck. You have all kinds of options. Choose one of the standard lanyards, or opt for a woven, silk screen, or dye sublimation lanyard. You can even choose lanyards designed for a cause such as breast cancer. You get quality and affordability with lanyards.

With so many badge reels available, there is certainly something to meet every company’s needs. With such affordable options you can mix and match to meet all of your badge reel needs.