Sutured point-fixation versus Jaboulay fixation for salvaged testicular torsion in children

BackgroundSurgical techniques for fixation of the testis are varied and subject to ongoing debate. Non-sutured techniques may avoid the theoretical morbidities of sutured fixation of the testis yet are criticized for insufficient prophylaxis against future torsion. This study aims to compare outcomes between sutured (point-fixation) versus Jaboulay fixation.MethodsEmergency scrotal explorations performed at a tertiary hospital in the state of South Australia between February 2002 and December 2017 were analyzed to identify cases of testicular torsion. Primary outcome measures included future testicular torsions and return to theater episodes following initial testicular fixation. Secondary outcome measures included re-presentations and post-operative complications.ResultsA total of 482 scrotal compartments were explored in 244 boys with acute testicular torsion. Testis fixation was performed using sutured point-fixation in 58.4% and Jaboulay tunica plication in 41.6%. No future testicular torsion occurred regardless of fixation technique. There were no significant differences in returns to theater (0.4% versus 1.2%, p = 0.12), re-presentations (6.9% versus 6.0%, p = 0.83), and post-operative complications (1.7% versus 1.8%, p = 1.0) in testes that previously underwent sutured or Jaboulay fixation, respectively.ConclusionJaboulay testicular fixation techniques are comparable with sutured point-fixation techniques in effectiveness and morbidity.Type of StudyTreatment Study.Level of EvidenceLevel III.     

An Easily Assembled,Low-Cost Model for Lateral Canthotomy Education

BackgroundLateral canthotomy is a vision-saving procedure. However, the low incidence of orbital compartment syndrome and the expense of simulators to practice this procedure can lead to low confidence and delays in the performance of the procedure by emergency physicians.DiscussionWe used a simple, inexpensive, easily assembled eye model for lateral canthotomy education at a residency program and a national conference obtaining feedback from simulation participants. Residents rated procedure laboratories that included the lateral canthotomy model as 4.9 to 5 (on a 5-point Likert scale, with 5 being the best score). National conference participants rated the model a 9 as a useful training model for practitioners on a 10-point Likert scale.ConclusionThis simple task trainer is practical, inexpensive, quickly assembled, and useful as a tool for practicing emergency medicine providers.     

Rosacea: a wholistic review and update from pathogenesis to diagnosis and therapy

Rosacea is a chronic inflammatory disorder of the central face with multiple overlapping presentations. Recent advancements are reshaping our understanding of rosacea from both a pathophysiologic perspective and clinical approach to therapy, introducing novel agents that have improved patient outcomes and reduced morbidity. In this article, we aim to outline the advancements in understanding, diagnosing, and managing rosacea and to familiarize physicians with the literature, thereby allowing us to better practice safe and effective medicine.     

Appearance Framing versus Health Framing of Health Advice: Assessing the Effects of a YouTube Channel for Adolescent Girls

ABSTRACT

The present experimental study tested the effects of appearance framing of health advice on adolescent girls’ state self-objectification, appearance anxiety, and preference for appearance-enhancing products. The stimuli consisted of informative YouTube-style videos about doing yoga, drinking water, or using sunscreen, and these videos were either appearance-framed (experimental condition) or health-framed (control condition). In total, 154 adolescent girls (M_age = 15.67, SD = 1.07) participated in the experiment. The effect of appearance-framed videos on state self-objectification scores was moderated by age, such that the effect of viewing the appearance-framed videos positively predicted state self-objectification among the younger adolescents. In addition, self-objectification mediated the effect of condition on appearance anxiety and on their appearance-enhancing product preferences, again with the predicted effects supported for the younger adolescents in the sample.