Dietary measures
Dietary modification, there is no evidence that any modification of protein or calorie intake can protect against pregnancy induced hypertension. Two trials from the Netherlands have compared advice to restrict dietary salt with continuing a normal diet. These were not large studies, and there is little suggestion of any effect on the development of pregnancy-induced hypertension or pre-eclampsia. Salt intake during pregnancy should, therefore, be a matter of taste and personal preference.
Dietary measures
Introduction of Hypertension in Pregnancy
Two etiologically distinct entities account for most hypertensive disorders in pregnancy. One is a disorder induced by pregnancy, which, in this chapter, we refer to as ‘pregnancy-induced hypertension’, if not accompanied by proteinuria, as ‘pre-eclampsia’ if there is associated proteinuria, and as ‘eclampsia’ if it leads to convulsions and/or coma. The other is chronic hypertension that precedes or coincides with pregnancy, and is sometimes associated with a known underlying condition, such as renal disease. In addition, a combination of the two conditions may occur; this is referred to as ‘superimposed pre-eclampsia’.
Introduction of Hypertension in Pregnancy
Fractures of the Mandible
1. What is the anatomy of the mandible?
The mandible is the largest and strongest of the facial bones. It consists of a basal bone and three processes. The basal bone extends from the symphysis at the chin to the lateral condyles on each side. In addition, it contains a horizontal portion, the body, and two perpendicular portions, the rami, which join the body at nearly right angles. The processes include the alveolar process, to which the teeth are attached; the coronoid process, to which the temporalis is attached; and the angle, to which the masseter and medial pterygoid muscles attach. The temporomandibular joint (TMJ) is a hinge joint to which the transverse head of the lateral pterygoid muscle attaches (Fig. 49-1). Fractures of the Mandible Fractures of the Mandible
Fractures of the Mandible
Regulation of Cardiac Muscle Performance: Regulatory Mechanisms in Cardiac and Skeletal Muscle
Alloplastic Implantation
1. What are the advantages of alloplastic materials? Alloplastic Implantation
•• No donor site morbidity from a second surgical site Alloplastic Implantation
•• Reduced operative time compared with harvesting a graft
•• Unlimited supply of alloplastic materials Alloplastic Implantation
•• Prefabricated implants can be tailored to the individual patient
•• Unlike autogenous materials (bone, cartilage, dermis, fat, fascia), there is no scar formation or reabsorption of the implant over time
2. How are biomedical alloplants classified? Alloplastic Implantation
Biomedical alloplants are classified as either liquids (injectable silicone, collagen) or solids (metals, polymers, ceramics). The physical form of the implants (solid or mesh, smooth or rough) determines whether the implant is encapsulated as a whole or whether fibrous tissue will penetrate the interstices of the implant. Selection of specific alloplastic implant materials can be advantageous in different clinical situations: vigorous tissue ingrowth into Marlex polypropylene mesh provides a strong, long-lasting repair, whereas fibrous encapsulation of a Hunter rod silicone tendon prosthesis ensures free gliding of a subsequent tendon graft. Alloplastic Implantation
Diseases of the Breast
1. What are the incidence, risk probability, and mortality for female breast cancer? Does radiation increase survival?
In 2004, it was estimated that 215,000 new cases of invasive breast cancer would be diagnosed and that 40,010 women would die of the disease. The incidence of breast cancer depends on whether a woman is in an average risk group or an increased risk group. Women at average risk have a 10% to 14% chance of having breast cancer by age 90 years. Diseases of the Breast
2. Which factors are known to increase the risk of breast cancer? What factors are known to decrease the risk of breast cancer? Diseases of the Breast
The strongest risk factor for the development of breast cancer is age. Race plays a role in risk as well, with whites having a higher risk than other racial groups. Breast cancer risk also is increased by nulliparity, high levels of combined exogenous estrogen and progestin, hyperplasia or proliferative pathology on previous breast biopsy, prior breast cancer on the contralateral side, greater breast tissue density, physical inactivity, and prior radiation exposure. Breast cancer risk is reduced by young age at first live birth. Oral contraceptive use is not associated with increased risk of breast cancer.
Plastic Surgery: Techniques and Geometry of Wound Repair remaining details
Techniques and Geometry of Wound Repair remaining details
20. When should scar revision be performed? What are the goals?
Scar revision should be performed once the scar has matured—usually 9 months to 2 years after the original procedure. The goals of scar revision are to reorient the scar, divide it into smaller segments, and make it level with adjacent tissue.
21. What is a Z-plasty?
Referred to by Limberg as “converging triangular flaps,” the Z-plasty is a technique in which two triangular flaps are interdigitated without tension, producing a gain in length along the direction of the common limb of the Z (useful in the management of scar contractures) as well as a change in the direction of the common limb of the Z (useful in the management of facial scars).
