Moss Memorial Health Clinic

Analysis of the face is an essential component of facial plastic surgery. In training, we are taught standards and ideals based on neoclassical models of beauty from Greek and Roman art and architecture. In practice, we encounter a wide range of variation in patient desires and perceptions of beauty. Our goals seem to be ever shifting, yet our education has provided us with a foundation from which to draw ideals of beauty. Plastic surgeons must synthesize classical ideas of beauty with patient desires, cultural nuances, and ethnic considerations all the while maintaining a natural appearance and result. This article gives an overview of classical models of facial proportions and relationships, while also discussing unique ethnic and cultural considerations which may influence the goal for the individual patient.

EVIDENCE-BASED ANSWER Rifaximin is as effective as other antibiotics or oral disaccharides for improving hepatic encephalopathy with a better safety profile (SOR: A, meta-analysis of RCTs). Combination therapy of rifaximin and lactulose is more effective for reversal of hepatic encephalopathy with less mortality than lactulose alone (SOR: B, RCT). Prophylactic use of rifaximin plus lactulose reduces hospitalizations for hepatic encephalopathy more than lactulose alone (SOR: B, RCT).

Since the discovery of the ubiquitous distribution of Vibrio parahaemolyticus in estuarine and coastal waters, several new species of the genus Vibrio have been identified as human pathogens during the past few years, including Vibrio vulnificus, Vibrio fluvialis, Vibrio hollisae, Vibrio damsela, and Vibrio mimicus. Brackish and estuarine waters have been identified as a common habitat for many of these and related Vibrio spp. Vibrio cholerae, the causative agent of epidemic cholera, has been isolated from a variety of clinical and environmental samples. The majority of V. cholerae from environmental sources have been non-01 serovars, although isolation of 01 serovars has been reported in areas where limited outbreaks of cholera have occurred(1).