Optimizing the nipple-areola sparing mastectomy with double concentric periareolar incision and biodimensional expander-implant reconstruction: Aesthetic and technical refinements

Although the biodimensional anatomical expander-implant system (BEIS) is a reliable technique, little information has been available regarding outcome following nipple-areola sparing mastectomy (NSM). To perform the resection of glandular tissue, while improving the surgical access and maintaining the nipple-areola vascularization we have developed a new approach for NSM based on the double concentric periareolar incision (DCPI). The purpose of this study is to analyze the feasibility, surgical planning and its outcome following NSM. 18 patients underwent NSM reconstructions. Mean time of follow-up was 29 months. The technique was indicated in patients with small/moderate volume breasts. Flap complications were evaluated and information on aesthetic results and patient satisfaction were collected. 83.3% had tumors measuring 2 cm or less (T1) and 72.1% were stage 0 and 1. All patients presented peripherally tumors located (at least 5 cm from the nipple). Skin complications occurred in 11.1%. One patient (5.5%) presented small skin necrosis and a wound dehiscence was observed in one patient (5.5%). The aesthetic result was good/very good in 94.4 percent and the majority of patients were very satisfied/satisfied. No local recurrences were observed. All complications except one were treated by a conservative approach. DCPI-BEIS is a simple and reliable technique for NSM reconstruction. The success depends on patient selection, coordinated planning with the oncologic surgeon and careful intra-operative and post-operative management. (C) 2009 Elsevier Ltd. All rights reserved.

A 2-year follow-up study of work ability among college educators

The aim of this study was to evaluate work ability among college educators before and after an intervention at the workplace. An administrative restructuring in the workplace started to be implemented in 2005. The work ability index (WAI) was administered to 154 educators before the restructure in 2004 and to 60 educators following the restructure in 2006. A mest comparing the WAI score of the 60 educators who took part in both phases showed a trend of improving work ability (p = 0.06; mean WAI in 2004 was 41.7 and 43.3 in 2006). The results suggest that the intervention led to an improvement in psychosocial factors, which in turn positively influenced work ability. (c) 2008 Elsevier Ltd. All rights reserved.

Columbia revisited: Paleomagnetic results from the 1790 Ma colider volcanics (SW Amazonian Craton, Brazil)

In an attempt to improve our understanding of the Paleoproterozoic geodynamic evolution, a paleomagnetic study was performed on 10 sites of acid volcanic rocks of the Colider Suite, southwestern Amazonian Craton. These rocks have a well-dated zircon U-Pb mean age of 1789 +/- 7 Ma. Alternating field and thermal demagnetization revealed northern (southern) directions with moderate to high upward (downward) inclinations. Rock magnetism experiments and magnetic mineralogy show that this characteristic magnetization is carried by Ti-poor magnetite or by hematite that replaces magnetite by late-magmatic cleuteric alteration. Both magnetite and hematite carry the same characteristic component. The mean direction (Dm = 183.0 degrees, Im = 53.5 degrees, N = 10, alpha(95) = 9.8 degrees, K = 25.2) yielded a paleomagnetic pole located at 298.8 degrees E, 63.3 degrees S (alpha(95) = 10.2 degrees, K = 23.6), which is classified with a quality factor Q = 5. Paleogeographic reconstructions using this pole and other reliable Paleoproterozoic poles suggest that Laurentia, Baltica, North China Craton and Amazonian Craton were located in laterally contiguous positions forming a large continental mass at 1790 Ma ago. This is reinforced by geological evidence which support the existence of the supercontinent Columbia in Paleoproterozoic times. (C) 2008 Elsevier B.V. All rights reserved.