RESUMEN
The techniques and cosmetic results of reduction mammaplasty have been well documented. However, pain is a major indication for undergoing this procedure, and symptom relief has rarely been addressed. This issue becomes particularly important in an era when medical costs are being increasingly scrutinized. The purpose of this study was to determine the effect of reduction mammaplasty on long-term morbidity related to chronic neck and back pain. Of 223 questionnaires distributed to patients who underwent reduction mammaplasty between 1984 and 1993, 177 questionnaires were returned. Two surgeons were involved, and all operations used the inferior pedicle technique, removing a minimum of 1,000 gm per patient. Seventy-four percent of patients were free of neck pain postoperatively versus 21% preoperatively. Similar results were obtained regarding back pain. Also 81% of those reporting severe neck or back pain before surgery currently have only mild or no pain. Analgesic use decreased from 44 to 17% (many of whom take pain medication for unrelated problems). Sixty-five percent of patients reported exercising more since surgery. Excellent patient satisfaction was confirmed as well. Breast shape and symmetry were "as expected or better." There was improvement in self-image for 88%, and 98% would recommend the procedure to others. Our dramatic functional results, combined with patient satisfaction and minimal morbidity, underscore the efficacy of breast reduction in medically indicated (symptomatic) cases.
Asunto(s)
Mamoplastia , Dolor de Espalda/etiología , Enfermedad Crónica , Ejercicio Físico , Femenino , Estudios de Seguimiento , Humanos , Cuello , Dolor/etiología , Satisfacción del Paciente , Complicaciones Posoperatorias , Autoimagen , Encuestas y Cuestionarios , Resultado del TratamientoRESUMEN
Benign Familial Neonatal Seizures (BFNS) occur in normal newborns without perinatal neurological damage or metabolic abnormalities in the setting of a positive family history for neonatal seizures. This autosomal dominant disorder has an excellent prognosis, in contrast to most other causes of neonatal convulsions. This paper points out the need to include BFNS in the differential diagnosis of neonatal seizures and to specifically seek a family history to avoid an unnecessarily extensive diagnostic evaluation and poor prognostication. We present a family with one atypical and three classic cases. Further study of BFNS may reveal more definitive basic science information leading to the inclusion of variant forms into the currently narrow clinical definition.