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BACKGROUND: Poland syndrome is a rare congenital condition characterized by unilateral breast deformity. Autologous fat transplantation has emerged as the preferred treatment due to its minimal invasiveness, rapid recovery, absence of rejection reactions, and potential for multiple surgeries to enhance postoperative outcomes. Previous animal studies have shown that botulinum toxin significantly improves fat retention rates following fat transplantation. Therefore, we aim to initiate a clinical study to investigate the effects of botulinum toxin on human fat transplantation. OBJECTIVE: This prospective comparative clinical study aims to evaluate the impact of combining botulinum toxin with autologous fat grafting on fat retention rates in patients with Poland syndrome. METHOD: From October 2017 to December 2023, we enrolled 20 Poland syndrome patients, assigning them to an experimental group receiving fat and botulinum toxin for breast augmentation and a control group undergoing standard autologous fat grafting. Postoperative fat retention rates were compared, and outcomes were assessed using the Breast-Q score, alongside baseline patient data. RESULTS: There were no significant differences in baseline data between the two groups. At 3 and 6 months postoperatively, the fat retention rate in the experimental group was significantly higher than that in the control group. Regarding Breast-Q scores, the control group exhibited significantly lower scores in the Satisfaction with breast domain than the experimental group, with no notable differences in other domains. CONCLUSION: The injection of a mixture of fat and botulinum toxin significantly enhances fat retention rates in patients with isolated breast deformities associated with Poland syndrome. TRIAL REGISTRATION: This study has been registered with the China Clinical Trial Center (ChiCTR2100054878).
Nowadays, biological therapies are booming and more of these formulations are coming to the market. Platelet-rich plasma, or PRP, is one of the most widely used biological therapies due to its ease of obtention and autologous character. Most of the techniques to obtain PRP are focusing on new processes and methods of optimization. However, not enough consideration is being given to modify the molecular components of PRP to generate more effective formulations with the aim of improving PRP treatments. Therefore, this review covers different novel PRP-obtaining methods that attempt to modify the molecular composition of the plasma.
Abstract Negative pressure wound therapy (NPWT) has significantly advanced wound care and continues to find new applications. Its effects at a molecular level however, remain a subject of debate. The aim of this systematic review is to summarize the current evidence regarding the molecular mechanisms of action of NPWT. Medline, Embase, EBSCO databases and clinical trial registries were searched from inception to January 2023. Clinical studies, animal models or in-vitro studies that quantitatively or semi-quantitatively evaluated the influence of NPWT on growth factors, cytokine or gene-expression in the circulation or wound-bed were included. Risk of Bias assessment was performed using the RoBANS tool for non-randomized studies, the COCHRANE's Risk of Bias 2(ROB-2) tool for randomized clinical studies, OHAT tool for in-vitro studies or the SYRCLE tool for animal model studies. A descriptive summary was collated and the aggregated data is presented as a narrative synthesis. This review included 19 clinical studies, 11 animal studies and 3 in-vitro studies. The effects of NPWT on 43 biomarkers and 17 gene expressions were studied across included studies. NPWT stimulates modulation of numerous local and circulating cytokines and growth factor expressions to promote an anti-inflammatory profile. This is most likely achieved by downregulation of TNF α , upregulation of VEGF, TGF- β and fibronectin.
Abstract This study aimed to explore the relationship of total social networking site (SNS) use and attitudes towards cosmetic surgery in young Australian women through the moderating role of self-compassion. Recent research has identified the potentially protective factor of self-compassion in body image concerns; however, few researchers have further explored the components of self-compassion in relation to SNS use. As such, the positive (self-kindness, common humanity, and mindfulness) and negative (self-judgement, isolation, and over-identification) components of self-compassion were further investigated. The present study utilised a cross-sectional correlational design with self-reported data to determine if self-compassion moderated the relationship between SNS use and attitudes towards cosmetic surgery. A sample of 238 young Australian women, aged 18 to 29 ( M = 22.1, SD = 2.9), were recruited. Participants completed an online questionnaire measuring total daily SNS use, self-compassion, and attitudes towards cosmetic surgery. SNS use was significantly negatively correlated with self-compassion and positively correlated with cosmetic surgery. Self-compassion was significantly negatively correlated with attitudes towards cosmetic surgery; however, contrary to expected, self-compassion was not a significant moderator of SNS use and attitudes towards cosmetic surgery. The components of self-compassion were further explored to better understand this relationship, with over-identification significantly predicting more positive attitudes towards cosmetic surgery. The present study highlights the relationship between SNS use and attitudes towards cosmetic surgery. As over-identification relates to ruminating in feelings of discomfort, the results may suggest that SNS users who are more likely to fixate on their appearance dissatisfaction are more likely to have positive attitudes towards cosmetic surgery. Given the popularity of SNS use, this media may pose as an opportune platform to disseminate appearance modification interventions for young adult women. Future research that is causational in nature may be able to confirm these suggested implications.
BACKGROUND: The application of polyhydroxy acids and alpha-hydroxy acids to the skin is often used in cosmetology. To enhance the effect of gluconolactone chemical peeling, a combined method including water-oxygen oxybrasion or microneedle mesotherapy can be used. OBJECTIVES: To evaluate skin parameters such as hydration, sebum, pH and TEWL after application of a 10% gluconolactone chemical peel in combination with oxybrasion and microneedling. MATERIALS AND METHODS: Twenty-one Caucasian women participated in the study. A series of three split face treatments was carried out at 1-week intervals. Oxybrasion was performed on the right side of the face and micro-needle mesotherapy on the left side. A 10% gluconolactone solution was applied to the entire face. Before the first and third treatments and 2 weeks after the last treatment, skin parameters were evaluated. Photographic documentation was also made before and after the treatment series. RESULTS AND CONCLUSION: Evaluation of skin parameters using Courage & Khazaka 580 Multi Probe Adapter probes (Courage + Khazaka electronic GmbH, Cologne, Germany) showed an increase in hydration and a decrease in sebum, pH and TEWL for both treatments. There were no statistically significant differences between the treatments. Combining chemical peeling of gluconolactone with oxybrasion and microneedle mesotherapy is a good method to seal the hydrolipid barrier and increase skin hydration.
The accuracy of clinical assessment techniques in diagnosing partial-thickness burn injuries has remained as low as 50-76%. Depending on the burn depth and environmental factors in the wound, such as reactive oxygen species, inflammation, and autophagy, partial-thickness burns can heal spontaneously or require surgical intervention. Herein, it is demonstrated that terahertz time-domain spectral imaging (THz-TDSI) is a promising tool for in vivo quantitative assessment and monitoring of partial-thickness burn injuries in large animals. We used a novel handheld THz-TDSI scanner to characterize burn injuries in a porcine scald model with histopathological controls. Statistical analysis (n= 40) indicates that the THz-TDSI modality can accurately differentiate between partial-thickness and full-thickness burn injuries (1-way ANOVA, p< 0.05). THz-TDSI has the potential to improve burn care outcomes by helping surgeons in making objective decisions for early excision of the wound.
Introdução: A palavra alimento funcional, pode ser descrita como qualquer matéria/ingrediente usada como alimento no auxílio da prevenção de doenças ou melhoria da qualidade de vida. O abacaxi é uma planta perene, pertencente à família Bromeliaceae, muito apreciado nas regiões produtoras e nos países importadores, devido suas características de aroma e sabor, mantendo equilíbrio entre o açúcar e acidez. A casca do abacaxi é um insumo não valorizado nas indústrias de alimentos, que pode auxiliar na dieta humana de forma complementar. Este estudo tem como objetivo divulgar a caracterização do abacaxi e sua casca apresentando suas propriedades por meio de uma revisão narrativa. Metodologia: Para o levantamento dos artigos científicos na literatura, realizou-se pesquisa através dos bancos de dados online da BVS, SCIELO, Science Direct, MEDLINE, LILACS e PMC, UFRGS, UFPA, SEBRAE, e Google School nos idiomas inglês, espanhol e português. Resultados e discussões: A composição química do abacaxi se diversifica sobretudo conforme a época do ano em que é gerada, sua diversidade e as condições atmosféricas, este apresenta valor energético, e alta composição de açúcar e valor nutritivo devido a presença de sais minerais (cálcio, fósforo, magnésio, potássio, sódio, cobre e iodo) e de vitaminas (C, A, B1, B2 e Niacina). Conclusão: A bromelina é uma enzima proteolítica encontrada no abacaxizeiro que mostram efeitos anti-inflamatórios, antitumoral, auxilia na digestão dos alimentos, anti-trombose, queimaduras e mucolítico.
Background and Objectives. Mastectomy skin flaps (MSF) necrosis is one of the most relevant complications following mastectomies with immediate breast reconstruction. The study evaluates a possible correlation between MSF qualitative and quantitative perfusion grade, using ICG angiography, and skin necrosis. Methods. Consecutive women scheduled for nipple/skin-sparing/skin-reducing mastectomy between May 2020 and April 2021 were prospectively enrolled. Patients were divided into Group 1 in the absence of superficial and full-thickness necrosis (SN; FTN) and Group 2 in the presence of both. T1 (time between ICG injection and the initial perfusion of the least perfused MSF area), ICG-Q1, and ICG-Q% (absolute and relative perfusion values of the least vascularized area) were collected. Results. 38 breasts were considered. FTN was reported in 4 breasts (10.5%) and SN in 3 (7.9%). The two groups statistically differ in T1 (Group2 > Group1) and ICG-Q% (Group1 > Group2) ( <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mi>p</a:mi> </a:math> < 0.05). T1 could statistically predict ICG-Q1 and ICG-Q%. Both quantitative values have a sensitivity of 57% and a NPV of 89%; ICG-Q% shows higher specificity (81% vs 77%) and PPV (40% vs 36%). Conclusions. Quantitative ICG angiography may additionally reduce MSF necrosis. Moreover, longer T1 may indicate possible postoperative necrosis. Considering these factors, intraoperative changes of reconstructive strategy could be adopted to reduce reconstructive failure.
The amalgamation of polymer and pharmaceutical sciences led to the introduction of polymer in the design and development of drug delivery systems. Polymeric delivery systems are mainly intended to achieve controlled or sustained drug delivery. Polysaccharides fabricated into hydrophilic matrices remain popular biomaterials for controlled-release dosage forms and the most abundant naturally occurring biopolymer is cellulose; so hdroxypropylmethyl cellulose, hydroxypropyl cellulose, microcrystalline cellulose and hydroxyethyl cellulose can be used for production of time controlled delivery systems. Additionally microcrystalline cellulose, sodium carboxymethyl cellulose, hydroxypropylmethyl cellulose, hydroxyethyl cellulose as well as hydroxypropyl cellulose are used to coat tablets. Cellulose acetate phthalate and hydroxymethyl cellulose phthalate are also used for enteric coating of tablets. Targeting of drugs to the colon following oral administration has also been accomplished by using polysaccharides such as hdroxypropylmethyl cellulose and hydroxypropyl cellulose in hydrated form; also they act as binders that swell when hydrated by gastric media and delay absorption. This paper assembles the current knowledge on the structure and chemistry of cellulose, and in the development of innovative cellulose esters and ethers for pharmaceuticals.
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To study the intelligent and efficient stock portfolio in China’s financial market, based on the relevant theories such as deep learning (DL) neural network (NN) and stock portfolio, this study selects 111 stable stocks from the constituent stocks of the China Security Index (CSI) 300 from January 1, 2018, to December 31, 2021, as the research samples. Then, it analyzes these research samples and imports the relevant data of 111 stocks into the DL NN model. The corresponding prediction results of stock prices are obtained. Finally, the stock portfolio model based on DL NN is compared with the data results of the Shanghai Stock Exchange (SSE) 50 Index and CSI 500 Index. The results show that the closing prices of the selected 111 stocks are relatively stable and fluctuate up and down around the horizontal axis, and the positive and negative returns are relatively balanced, roughly between −5% and 5%. There is a phenomenon of fluctuation aggregation to a certain extent. Comparing the prediction results of different models reveals that the prediction results of model c are closest to the actual stock price trend. Comparing the relevant returns of the proposed stock portfolio with other stocks uncovers that the annualized return of the stock portfolio based on the DL NN model is 47.44%. The sharp ratio is 1.52, the maximum pullback is 18.15%, the monthly excess return is 3.11%, and the information ratio is 0.82. Compared with other indexes, the proposed stock portfolio shows the best results. Therefore, the proposal of the stock portfolio based on DL NN provides a theoretical basis for the development of the financial field in the future.
<strong>Summary.</strong> Bacteria from <em>Acinetobacter calcoaceticus-A. baumannii</em> (Acb) complex are widespread, multi-drug resistant bacteria of great clinical importance. The aim of this study was to determine the most suitable sole carbon source for their isolation/cultivation from environmental samples, to facilitate easier isolation and to compare the properties of environmental strains and wound isolates, in order to reveal whether environmental isolates are a reservoir of infection. In addition to acetate, which is used in routine procedures, the most appropriate carbon sources for isolation, were alanine, L-histidine and L-tyrosine. Because none of the substrates enabled isolation from all samples, new carbon sources or their combinations should be further considered. In subculture, L-tyrosine, alanine, L-histidine and pyruvate were the most appropriate for bacterial growth. Environmental and clinical strains were identified using classical methods and multiplex PCR, and out of 31 strains two were not identified as <em>A. baumannii</em>, but as other members of the Acb complex (13 UT group). All strains possessed integron class 1, while all environmental isolates and one clinical strain possessed integron class 2. Integron class 2 should be further examined as a marker for environmental strains. The environmental strains were multi-drug resistant and there was no statistical difference in antibiotic resistance in comparison to clinical strains (<em>p</em> = 0.36). The detected similarity of RAPD-PCR fingerprints among <em>A. baumannii</em> environmental and wound isolates, suggests their epidemiological relatedness, raising the urgency for finding adequate solutions for prevention of further resistance dissemination among strains of different origins.
INTRODUCTION: The osteocutaneous fibula is a workhorse flap for oromandibular reconstruction. Skin paddles not only perform soft tissue reconstruction but also serve as a monitor for the fibula. In cases where the skin paddle cannot be harvested as desired due to variations, two challenges arise, such as fibula follow-up and the need for a second free flap so recipient. Moreover, there may not be enough recipient vessels for the double flaps in the neck. This report aimed to address the difficulties mentioned above with the use of flow-through free flaps in composite oromandibular reconstructions. PATIENTS AND METHODS: Between 2019 and 2021, five (three Female, two Male) patients underwent flow-through technique as free fibula and fasciocutaneous flaps due to variations in fibular skin paddle or insufficiency of recipient vessels in the neck. Ages of patients were between 45 and 75 years. Four patients underwent surgery for tumor and one patient for the result of radionecrosis. ALT, chimeric ALT, and RFFF were selected as second free flaps. RESULTS: The size of the fasciocutaneous flaps ranged from 6 × 4 cm to 14 × 11 cm. Mandibular defects ranged from 6 to 16 cm. 1 venous occlusion occurred post-op 1st day and was salvaged. One hematoma and one wound dehiscence occurred postoperatively and were salvaged successfully. One Partial tongue necrosis occurred due to previous radiotherapy and additional tumor surgery. No additional complication occurred. All flaps survived. Follow-up period was between 3 months and 2 years. Patient who had tongue necrosis experienced swallowing and speech difficulty and Percutaneous endoscopic gastrostomy tube was placed post-operative 2 months. Functional finale outcomes were successful for other patients. CONCLUSION: Flow-through technique provides fibula monitoring with avoiding to find second recipient. Customizing free flaps under more favorable conditions as on the operation table before fixation of the bone can be a useful approach.
Biotechnology and nanotechnology are the key technologies of the twenty-first century, having enormous potential for innovation and growth. The academic and industrial goals for these technologies are the development of nanoscale biomolecular substances and analytical instruments for investigating cell biology at the cellular and molecular levels. Developments in nanotechnology will provide opportunities for cosmetic dermatology to develop new biocompatible and biodegradable therapeutics, delivery systems and more active compounds. Cosmetics have the primary function of keeping up a good appearance, changing the appearance, or correcting body odors, while maintaining the skin and its surroundings in good conditions. Thus cosmetic dermatology, recognizing the new realities of skin care products, has to emphasize the functional aspects of cosmetics through an understanding of their efficacy and safety in promoting good health. Nanoscience may help the scientific community to find more innovative and efficacious cosmetics. Understanding the physical model of the cell as a machine is essential to understand how all the cell components work together to accomplish a task. The efficacy and safety of new nanomaterials has to be deeply studied by ex vivo tests and innovative laboratory techniques. New delivery systems and natural nanocompounds, such as chitin nanofibrils for wound healing, are being used in cosmetic dermatology with good results, as are nanostructured TiO(2) and ZnO sunscreens. The challenge is open.
AIMS/BACKGROUND: The aim of this study was to assess the morbidity associated with harvesting autogenous fascia lata for brow suspension ptosis surgery. METHODS: A retrospective study by postal questionnaire of 24 consecutive patients. RESULTS: Early postoperative problems with pain on walking (67%), limping (38%), and wound pain (57%) occurred mostly for less than 1 week. The final cosmetic appearance of the scar caused minor concern in 38% of patients. CONCLUSION: Fascia lata is the preferred material for permanent ptosis correction when a brow suspension is required. Most of the patients, following fascia lata harvest, experienced some symptoms of leg pain and limping for less than 1 week. The only long term problem was the scar. 38% of patients found the final cosmetic appearance caused minor concern.
BACKGROUND: Dipyrone (metamizole) is a nonsteroidal anti-inflammatory drug used in some countries to treat pain (postoperative, colic, cancer, and migraine); it is banned in other countries because of an association with life-threatening blood disorders. This review replaces a 2010 Cochrane review that has been withdrawn. OBJECTIVES: To assess the analgesic efficacy and associated adverse events of single dose dipyrone for moderate to severe acute postoperative pain using methods that permit comparison with other analgesics evaluated in standardised trials using almost identical methods and outcomes. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and LILACS to 11 August 2015; the Oxford Pain Relief Database; two clinical trial registries; and the reference lists of articles. SELECTION CRITERIA: We included randomised, double-blind, placebo-controlled trials of single dose dipyrone for relief of established moderate to severe postoperative pain in adults. We accepted oral, rectal, intramuscular, and intravenous routes of administration. DATA COLLECTION AND ANALYSIS: Two review authors independently considered studies for inclusion in the review, assessed risk of bias, and extracted data. We used summed total pain relief or pain intensity difference (TOTPAR or SPID) over four to six hours to calculate the number of participants achieving at least 50% pain relief. From derived results, we calculated the risk ratio and number needed to treat for an additional beneficial outcome (NNT), with 95% confidence intervals (CI), for one participant to experience at least 50% pain relief over four to six hours compared to placebo. We looked at use of rescue medication and time to use of rescue medication as additional measures of efficacy. We also looked for information on adverse events and withdrawals. MAIN RESULTS: We included eight studies, involving 809 participants, comparing oral dipyrone 500 mg (143 participants), oral dipyrone 1000 mg (57 participants), and intramuscular dipyrone 2000 mg (35 participants) with placebo (236 participants). In addition to placebo, all studies used active controls (ibuprofen, paracetamol, aspirin, flurbiprofen, ketoprofen; 338 participants). Seven studies used the oral route of administration, and one study used the intramuscular route. The mean age ranged from 23 to 62 years. Six studies included both men and women, and two studies included only women. All the studies were small, but were otherwise of moderate to good quality.Over 70% of participants experienced our primary outcome of at least 50% pain relief over four to six hours with oral dipyrone 500 mg compared to 30% with placebo (five studies, 288 participants; NNT 2.4 (95% CI 1.8 to 3.1)) (moderate quality evidence). There were insufficient data to assess other doses or routes of administration of dipyrone.Fewer participants needed rescue medication within four to six hours with dipyrone 500 mg than with placebo (7% with dipyrone versus 34% with placebo; four studies, 248 participants) (low quality evidence).The data on numbers of participants experiencing any adverse event was inconsistently reported and no analysis was possible. No serious adverse events or adverse event withdrawals were reported (very low quality evidence).There were too few data to compare dipyrone directly with other active treatments. AUTHORS' CONCLUSIONS: Based on very limited information, a single dose of dipyrone 500 mg provides good pain relief to about 70% of people treated, compared to about 30% with placebo. For every five people given dipyrone 500 mg, two people would experience this level of pain relief over four to six hours who would not have done with placebo, and fewer people would need rescue medication.We were unable to compare dipyrone directly with other active treatments, or to assess the effects of different doses or routes of administration, or the number of participants experiencing adverse events, because of insufficient data and inadequate reporting.
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BACKGROUND: Many techniques have been described for reconstruction of the vaginal canal for oncologic, traumatic, and congenital indications. An increasing role exists for these procedures within the transgender community. Most often, inverted phallus skin is used to create the neovagina in transwomen. However, not all patients have sufficient tissue to achieve satisfactory depth and those that do must endure cumbersome postoperative dilation routines to prevent contracture. In selected patients, the sigmoid colon can be used to harvest ample tissue while avoiding the limitations of penile inversion techniques. METHODS: Records were retrospectively reviewed for all transwomen undergoing primary sigmoid vaginoplasty with the University of Miami Gender Reassignment service between 2014 and 2017. RESULTS: Average neovaginal depth was 13.9 +/- 2.0 centimeters in 12 patients. 67% were without complications, and all maintained tissue conducive to sexual activity. No incidences of bowel injury, anastomotic leak, sigmoid necrosis, prolapse, diversion neovaginitis, dyspareunia, or excessive secretions had occurred at last follow-up. CONCLUSIONS: Sigmoid vaginoplasty is a reliable technique for achieving a satisfactory vaginal depth that is sexually functional. Using a collaborative approach, it is now our standard of care to offer this surgery to transwomen with phallus length less than 11.4 centimeters.
BACKGROUND: Improved imaging and refined technology have led to a number of recent advances in the surgical treatment of faecal incontinence. METHODS: Original articles, identified using a computer database (Medline), and recently published abstracts of meetings were selected on the basis of greatest clinical relevance; these were reviewed. RESULTS: Ultrasonographic characterization has led to improved therapeutic strategies. Simple structural damage is readily identified and external sphincter repair results in a good outcome for a majority of patients. For more complex structural damage, or for the newly recognized primary internal sphincter degeneration, alternative treatment strategies are emerging. The electrically stimulated gracilis neosphincter and the artificial bowel sphincter offer good results. The latter may be a more simple operation. For structurally intact but weak sphincters, sacral nerve stimulation is a promising therapy. Other therapies, such as antegrade irrigation, may be helpful for patients with neurological disorders. CONCLUSION: Better imaging, refined classification and new operations are leading to improved surgical techniques for faecal incontinence.