Abstract:
:Systemic corticosteroid therapy has been used to treat hemangiomas for 30 years; yet, there are no studies of possible complications. We reviewed the database of the Vascular Anomalies Center at the Boston Children's Hospital and gathered information on short- and long-term side effects in children who were given systemic corticosteroids for problematic hemangiomas. In addition, a questionnaire regarding early and late consequences was sent to the families of children who were treated with corticosteroids from 1983 to 1997. Of 300 patients with hemangiomas, 80 children were identified as having received a full course of systemic corticosteroids for problematic tumors. Complete data were collected on 62 of these children. The response rate to the questionnaire was 78 percent (n = 62 of 80). The initial dose of corticosteroid varied from 2 to 3 mg/kg/ day. Duration of therapy ranged from 2 to 21 months (mean, 7.9 months; median, 6.5 months). The follow-up interval from the cessation of therapy ranged from 6 months to 15 years (mean, 4 years; median, 3 years). Short-term complications included cushingoid facies (n = 44; 71 percent), personality changes (n = 18; 29 percent), gastric irritation (n = 13; 21 percent), fungal (oral or perineal) infection (n = 4; 6 percent), and diminished gain of height (n = 22; 35 percent) and weight (n = 26; 42 percent). A total of 91 percent of children who had diminished gain of height (n = 20) returned to their pretreatment growth curve for height by 24 months of age. One child, who was treated at another institution with a dose of 20 mg/kg/day for 6.5 months that was slowly tapered over 18 months, was petite 6 years after ending therapy. Another child treated with an initial dose of 2 mg/kg/day for 5 months was smaller than predicted at the age of 6 years, but she was born prematurely and was on ventilatory support for respiratory distress. Three children treated with the standard dose and duration were at a low percentile for weight 4, 5, and 10 years after the cessation of therapy. Statistical analysis showed a correlation between diminished gain of height with duration of therapy and age at initiation of treatment. One child had corticosteroid myopathy that resolved with cessation of therapy. We found no evidence for immunologic suppression, i.e., there was no increase in the number of bacterial infections during corticosteroid administration. In conclusion, systemic corticosteroids can be safely given to treat endangering hemangiomas in infants at doses of 2 to 3 mg/kg/day, which are slowly tapered and stopped before the age of 1 year. Short-term side effects were minor and transient, and no serious long-term complications occurred.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Boon LM,MacDonald DM,Mulliken JBdoi
10.1097/00006534-199911000-00002subject
Has Abstractpub_date
1999-11-01 00:00:00pages
1616-23issue
6eissn
0032-1052issn
1529-4242journal_volume
104pub_type
杂志文章abstract:BACKGROUND:To plan abdominal perforator-based microsurgical breast reconstruction, duplex ultrasound is often employed to preoperatively identify the location of abdominal wall perforating vessels. Recently, several groups have published the use of computed tomography angiography for preoperative planning in perforator...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
doi:10.1097/PRS.0b013e3181c82d24
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate the case mix of plastic surgeons in their early years of practice by examining candidate case logs submitted for the oral examination. METHODS:Deidentified data from 2000 to 2009 consisting of case logs submitted by young plastic surgery candidates for the oral exam...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31821b6307
更新日期:2011-08-01 00:00:00
abstract::Tissue factor pathway inhibitor is a naturally occurring protein inhibitor of factor X and the tissue factor-factor VII complex of the extrinsic pathway of coagulation. The potential of tissue factor pathway inhibitor as a topical antithrombotic agent was evaluated in a rabbit model of thrombosis that combined intimal...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199603000-00015
更新日期:1996-03-01 00:00:00
abstract::The purpose of this study was to review the long-term results in anophthalmic patients treated for enophthalmos. The patients in our series had augmentation of the volume of their orbital contents by subperiosteal placement of room-temperature vulcanized silicone. From 1972 to 1985, sixty-three patients received subpe...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198703000-00001
更新日期:1987-03-01 00:00:00
abstract::Free-tissue transfer in the elderly has received increasing attention in the literature. Existing reports are limited by small samples or inadequate definition of the term elderly. This study reviewed 5 years' experience with free-tissue transfer in a geriatric population (mean age 75 years, range 70 to 83 years). For...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00006534-199612000-00018
更新日期:1996-12-01 00:00:00
abstract::Several factors may increase a patient's risk for perioperative pulmonary complications. This practice advisory provides an overview of the preoperative steps that should be performed to ensure appropriate patient selection and patient safety with regard to pulmonary complications. Procedural and patient-related risk ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e3181b53fb0
更新日期:2009-10-01 00:00:00
abstract::A graphic and written anatomic data sheet (ADS) for facial aesthetic surgery and body contour surgery is presented as a tool for: (1) analyzing surgical maneuvers and their effect on final outcome; (2) recording individual anatomic variations; (3) communicating data between office personnel and colleagues; (4) aiding ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199304000-00030
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:Penile inversion vaginoplasty is considered to be the gold standard for gender reassignment surgery in transgender women. The use of additional full-thickness skin graft as neovaginal lining is controversial. Some believe that having extra penile skin for the vulva gives better aesthetic results. Others beli...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003108
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:Despite well-established correlation of postmastectomy radiotherapy and surgical complications in breast reconstruction, its impact on patient reported outcomes is less clear. We sought to determine the effect of postmastectomy radiotherapy on patient reported outcomes throughout the breast reconstruction pr...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000004105
更新日期:2018-03-01 00:00:00
abstract::In a previous study in the rabbit, it was demonstrated that paralysis of the midfacial musculature results in decreased anteroposterior growth of the snout. At the end of growth, these animals showed macroscopically striking similarities to animals with unilateral fusion of the nasofrontal suture. In this study, wheth...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199906000-00013
更新日期:1999-06-01 00:00:00
abstract:BACKGROUND:Monobloc distraction has been demonstrated to be an efficacious, safe, and stable method of providing functional and aesthetic improvement in children with syndromic craniosynostosis. Although the movement of bony structures following monobloc distraction has been quantitatively assessed before, objective an...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181a07625
更新日期:2009-05-01 00:00:00
abstract::In this paper, the treatment of a complicated Achilles tendon defect with a composite lateral arm flap with distal design of the skin paddle has been presented. The extended portion of the flap was sufficient to restore adequate contour to the posterior aspect of the ankle, and reinervation showed good protective sens...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199810000-00044
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:Regenerative medicine aims to obviate the need for autologous grafting through the use of bioengineered constructs that combine stem cells, growth factors, and biocompatible vehicles. Human mesenchymal stem cells and vascular endothelial growth factor (VEGF) have both shown promise for use in this context, t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000001199
更新日期:2015-05-01 00:00:00
abstract:LEARNING OBJECTIVES:After studying this article, the participant should: 1. Be able to define indications and timing for secondary cranioplasty. 2. Understand the surgical options for reconstructing the cranium and overlying soft-tissue defect including their advantages and disadvantages. 3. Be able to apply this knowl...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e3181858eee
更新日期:2008-12-01 00:00:00
abstract::Increased production of oxygen free radicals and infiltration of neutrophils into tissue subjected to ischemia-reperfusion have emphasized that neutrophils play a direct role in the development of injury. The present study was designed to elucidate the effect of FK506, a new immunosuppressive drug, on 11 hours of comp...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199807000-00024
更新日期:1998-07-01 00:00:00
abstract:BACKGROUND:Although the introduction of acellular dermal matrices is considered one of the most important advancements in alloplastic breast reconstruction, costs and local policy limit their use in Italy. The purpose of this study was to assess short-term outcomes following Surgimesh-PET-based breast reconstruction. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000002180
更新日期:2016-06-01 00:00:00
abstract::Rheumatoid arthritis affects approximately 1 percent of the adult population. Bilateral symmetric involvement of the wrist occurs in 85 percent of these patients, with recurrent flares and relentless progression. Anatomic changes consist of radiocarpal, intercarpal, and radioulnar subluxation and joint destruction. Fo...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199912000-00018
更新日期:1999-12-01 00:00:00
abstract::The most common complication in flap surgery is of a circulatory nature. Impeded blood flow leads to altered metabolism in the tissue. Possible metabolic differences between different zones of the transverse rectus abdominis muscle (TRAM) flap were studied and the metabolism of pedicled and free TRAM flaps was compare...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200202000-00037
更新日期:2002-02-01 00:00:00
abstract::An alternative method for the repair of rhombic skin defects utilizing opposing Z-plasties has been developed and applied clinically. The design, orientation, and execution of this method share the simplicity of the Z-plasty. The technique has been employed successfully in over 100 cases during the past 5 years to res...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198305000-00014
更新日期:1983-05-01 00:00:00
abstract:BACKGROUND:Although in modern medicine, patients' preferences are important, these have never been defined for characteristics of Dupuytren treatment. This study determines these patients' preferences using a discrete choice experiment. METHODS:A multicenter discrete choice experiment study was conducted among patient...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/PRS.0000000000001878
更新日期:2016-01-01 00:00:00
abstract::We have used a modification of a mucoperiosteal flap described by Lane for cleft palates in 3 patients with oral cavity defects from tumor ablations. The flap provides excellent lining for repairs when alternative flaps are unavailable. The vascularity of the flap and its texture allow a watertight closure which does ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197610000-00010
更新日期:1976-10-01 00:00:00
abstract:BACKGROUND:Transconjunctival blepharoplasty remains a popular and safe technique to treat periorbital aging. In the lower lid, it can be used successfully for orbital fat excision, redistribution, or septal tightening. In the upper lid, transconjunctival blepharoplasty has a role in removal of the nasal fat pad via an ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181c2a534
更新日期:2010-01-01 00:00:00
abstract::An animal model was developed to determine the ability of capacitively coupled electrical fields to enhance onlay bone graft survival in the craniofacial skeleton. Fifteen male New Zealand white rabbits were divided into control and stimulated groups. Blocks of iliac bone were transplanted as onlay grafts to the mandi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198810000-00003
更新日期:1988-10-01 00:00:00
abstract::Dimpling of the skin of the thighs and buttocks is commonly referred to as cellulite, and it afflicts women much more frequently than men. Whereas many therapies that presume cellulite is caused by an abnormality of adipose tissue have gained recent popularity, the basic pathophysiology of cellulite has not been clear...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199806000-00025
更新日期:1998-06-01 00:00:00
abstract::Six cases of strawberry hemangioma have been presented in which some form of intervention in tumor progression was indicated. The argon laser was used. All six cases showed loss of surface vascularity. Growth was clearly arrested in four of the six. Premature regression could be definitely claimed in only one. The str...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198304000-00005
更新日期:1983-04-01 00:00:00
abstract::Plagiocephaly is a descriptive term that connotes an asymmetrically oblique or twisted head. Such cranial dysmorphology has a number of etiologies, the most common of which are unicoronal synostosis, unilambdoid synostosis, and plagiocephaly without synostosis. Use of the term plagiocephaly in the literature is often ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199602000-00003
更新日期:1996-02-01 00:00:00
abstract:LEARNING OBJECTIVES:After reading this article and watching the accompanying videos, the participant should be able to: 1. Assess patients seeking facial volumization and correlate volume deficiencies anatomically. 2. Identify appropriate fillers based on rheologic properties and anatomical needs. 3. Recognize poor can...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000002238
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:The management of hypertrophic scars and keloids remains a therapeutic challenge. Treatment regimens are currently based on clinical experience rather than substantiated evidence. Laser therapy is an emerging minimally invasive treatment that has recently gained attention. METHODS:A meta-analysis was conduc...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1097/PRS.0b013e3182a97e43
更新日期:2013-12-01 00:00:00
abstract::A simple technique for closure of a palatal fistula using a conchal cartilage graft as a substitute for nasal lining flaps is reported. This graft simplifies the repair of the palatal fistula and protects the suture line of the oral covering flaps from recurrence. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199108000-00029
更新日期:1991-08-01 00:00:00
abstract::A technique for orienting cut nerve ends for suturing is presented. A mirror is used to reflect one end, making its image identical to that of the other end--so that proper orientation is greatly facilitated. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197901000-00033
更新日期:1979-01-01 00:00:00