scholarly journals Hyaluronic Acid Fillers Enriched with Glycine and Proline in Eyebrow Augmentation Procedure

2021 ◽  
Author(s):  
Antonio Scarano ◽  
Biagio Rapone ◽  
Domenico Amuso ◽  
Francesco Inchingolo ◽  
Felice Lorusso
Keyword(s):  
Hyaluronic Acid ◽  
Full Description ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Aesthetic Result ◽  
Study Results ◽  
High Level ◽  
Based Medicine ◽  
Augmentation Procedure

Abstract Background The eyebrow area is a clinically critical district due to the anatomical complexity and the propensity to aging-related atrophy. Hyaluronic acid fillers have been proposed to recover the dermal volume of the facial and lips regions. Aim The aim of the present investigation was to evaluate hyaluronic acid fillers enriched with glycine and proline for the treatment of eyebrow augmentation. Methods A total of 15 healthy patients were treated with eyebrow augmentation procedure. The distance between mid-bipupil to lateral eyebrow and mid-eyebrow to the medial eyebrow was measured before, immediately after treatment and at follow-up of 6 months. Results The healing period was uneventful, and no evidence of inflammation or swelling associated with the treatment was reported. No macroscopical alteration was reported in the surrounding tissues with no evidences of visible wheals or lumps in the treated sites at the follow-up. Before treatment, the angle was equal to 9.32 ± 0.2°, while after treatment it was 11.21 ± 0.4° (p < 0.01); after three and 6 weeks, it was, respectively, 10.66 ± 0.2° (p<0.05) and 10.02 ± 0.3°(p > 0.05). Conclusions The study results suggest that the hyaluronic acid fillers enriched with glycine and proline treatment resulted as being a useful procedure for augmentation, contour and volume definition and elevation of the eyebrow region with a high-level aesthetic result. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

scholarly journals Combining Calcium Hydroxylapatite and Hyaluronic Acid Fillers for Aesthetic Indications: Efficacy of an Innovative Hybrid Filler

2021 ◽  
Author(s):  
Nabil Fakih-Gomez ◽  
Jonathan Kadouch
Keyword(s):  
Hyaluronic Acid ◽  
Adverse Events ◽  
Retrospective Chart Review ◽  
Full Description ◽  
Limited Data ◽  
Level Of Evidence ◽  
Hybrid Filler ◽  
Calcium Hydroxylapatite ◽  
Study Support ◽  
Based Medicine

Abstract Background Limited data are available describing effectiveness of combining the use of calcium hydroxylapatite (CaHA) and hyaluronic acid (HA). Methods The authors performed a retrospective chart review of patients injected with a premixed combination of CaHA and a cohesive polydensified matrix (CPM®) HA (CaHA:CPM-HA ) in the authors’ aesthetic practices. The midface and lower face were injected. Patients’ records were evaluated, and treatment results were scored using the Merz Aesthetics Scale for the jawline® (clinician rated, CR-MASJ). Adverse events were recorded. Results A total of 41 patients were included, all females with a mean age of 47.5 years (range 21–63 years). The mean CR-MASJ score improved from 2.12 at baseline to 0.68 at t = 3 months (SD = 0.69, 95% CI 1.28–1.60) and 1.27 at t = 12 months (SD = 0.74, 95% CI 0.43–0.74). 100% of the subjects had experienced a ≥1-point improvement in CR-MASJ score at t = 3 months, versus 85% at t = 12 months. No adverse events were reported. Conclusion The results of this study support the volumizing and lifting potential of the hybrid mix CaHA:CPM-HA for treatment of cheeks and jawline. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

scholarly journals Clinical Efficacy and Safety of Non-Cross-Linked Hyaluronic Acid Combined with L-carnosine for Horizontal Neck Wrinkles Treatment

2021 ◽  
Author(s):  
Shiwei Wang ◽  
Huanyun Niu ◽  
Yao Liu ◽  
Yawen Tan ◽  
He Gao ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Adverse Events ◽  
Treatment Plan ◽  
Treatment Options ◽  
Critical Role ◽  
Full Description ◽  
Efficacy And Safety ◽  
Level Of Evidence ◽  
Filler Injection ◽  
Based Medicine

AbstractBackground Horizontal neck wrinkle formation is gaining more attention among cosmetic practitioners and clients. To date, hyaluronic acid products are one of the most common treatment options for this aesthetic concern. However, different therapeutic strategies should be given to solve the problem due to multiple etiological reasons. Given that oxidative damage plays a critical role in neck wrinkle formation, anti-oxidative compounds are now considered by physicians when making a treatment plan. Aims To evaluate the efficacy and safety of a non-cross-linked hyaluronic acid filler in combination with L-carnosine in treating horizontal neck wrinkles. Methods Thirteen patients with a Wrinkle Assessment Scale (WAS) of 2–5 for horizontal neck wrinkles were treated with L-carnosine-containing non-cross-linked hyaluronic acid. Participants were followed-up for 3 months after treatment. The post-treated WAS scores evaluated by physicians were collected when patient satisfaction was surveyed. Any post-treatment adverse events were recorded. Results With a single injection of the above filler, the physician-evaluated WAS scores improved by at least one score at one month and the improvement kept consistent as far as three months after injection. According to the last follow-up visit, 11/13 patients were satisfied with the treatment effect of their neck wrinkle. Moreover, adverse events were rare after filler injection, except for local complications that were considered common reactions to the filler injection procedure. Conclusion The non-cross-linked hyaluronic acid filler containing L-carnosine is safe and effective for treating horizontal neck wrinkles.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

scholarly journals Defining the Inframammary Fold by Liposuction: An Essential Tool in Aesthetic Shaping of the Reconstructed Breast. Technique and Long-term Results in a Series of Patients

2021 ◽  
Author(s):  
Valentina Pinto ◽  
Marco Pignatti ◽  
Luca Contu ◽  
Riccardo Cipriani
Keyword(s):  
Evidence Based Medicine ◽  
Experimental Studies ◽  
Long Term Results ◽  
Inframammary Fold ◽  
Full Description ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Definition Of ◽  
Based Medicine

Abstract Background A good inframammary fold (IMF) definition and position is essential to achieve a satisfactory and natural result in breast surgery. This structure can be damaged, especially during mastectomies. Multiple methods are reported in the literature to restore IMF or improve its definition. In this study, we present the results achieved in a series of patients treated with subdermal liposuction. Methods We report on all our patients who underwent IMF liposuction between January 2016 and June 2020. Subdermal liposuction was performed with a blunt 3 mm cannula along the new IMF to promote skin retraction and adherence between skin and fascia. Results were evaluated subjectively by the patients and objectively by 8 individuals not involved with the treatment. Results We performed IMF liposuction in 88 breasts (69 patients), aged 21–74 (mean 52) years for 82 implant-based reconstructions, 2 tuberous breasts, and 4 contralateral breast augmentations. Mean follow-up was 28 months (6–64). Subjective results: the overall result evaluated with the VAS scale reached 86.6/100. All the 22 patients interviewed judged as well defined the new inframammary fold. Objective results: in 83% of cases the definition of the inframammary fold was judged as good or excellent, while symmetry with contralateral IMF, natural appearance, and overall aesthetic outcome were judged as good. Conclusion Based on our long-term satisfactory results, we recommend the technique of subdermal liposuction to improve the definition of IMF in breast reconstruction after mastectomy and other breast procedures. It is effective, easy to perform, minimally invasive, and durable. Level of Evidence IV This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

scholarly journals Conservative treatment of hallux rigidus: narrative review of scientific evidence

2021 ◽  
Vol 15 (3) ◽  
pp. 201-204
Author(s):  
Mario Herrera-Perez ◽  
David González-Martín ◽  
Javier Ruiz-Escobar ◽  
Ramón Viladot-Pericé
Keyword(s):  
Systematic Review ◽  
Hyaluronic Acid ◽  
Conservative Treatment ◽  
Evidence Based Medicine ◽  
Scientific Evidence ◽  
Hallux Rigidus ◽  
Narrative Review ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Based Medicine

This study proposes an update on conservative treatment of hallux rigidus based on scientific evidence. This is a narrative review of 19 articles that analyzed conservative treatment of hallux rigidus in its different modalities. Conservative treatment is effective in approximately half of the patients with hallux rigidus, and footwear modifications, use of insoles, and hyaluronic acid injections are the most effective treatments, according to evidence-based medicine. Level of Evidence III; Therapeutic Studies; Systematic Review of Level III Studies.

scholarly journals Application of a Proposed Multi-Positional Circumferential Arm Liposuction Method and Quantification of its Clinical Efficacy Evaluation

2021 ◽  
Author(s):  
Yunpeng Gu ◽  
Ning Kang ◽  
Qianwen Lv ◽  
Yue Qi ◽  
Zhenjun Liu ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Quantitative Research ◽  
Three Dimensional ◽  
Reduction Rate ◽  
Full Description ◽  
Type I ◽  
Efficacy Evaluation ◽  
Level Of Evidence ◽  
Simple Measurement ◽  
Based Medicine

Abstract Background Upper arm liposuction mainly focuses on the posterolateral region, which may lead to a lack of harmony between the aspirated and unaspirated areas. In addition, the treatment effect of arm liposuction is often evaluated only by preoperative and postoperative photograph comparison and simple measurement; quantitative research on this topic is still lacking. Methods The multi-positional circumferential arm liposuction (MCAL) technique was proposed and applied to a total of 34 females in our hospital from 2017 to 2019. Three-dimensional data of 12 patients before the operation and after 2–3 months were collected and processed by 3D imaging, and the volume reduction rate was evaluated quantitatively. Results The MCAL method was successfully applied in the clinic, and its surgical effect was quantitatively studied. The mean follow-up time of 12 patients was (75.2 ±13.1) days, and the postoperative volume was significantly reduced. The postoperative volume of patients with type I, type II and type III decreased by (10.79 ±2.55)%, (17.25 ±3.02)% and (22.76 ±3.51)%, respectively. Conclusion Our new MCAL technique was successful, maximizing the esthetic results in upper limb contour refinements in the superficial fascial layer. The clinical efficacy of this proposed MCAL method was evaluated by CT and 3D digital technology, which provided further accuracy in demonstrating its effect on the shape of the arm. Level of evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com.

A Blueprint for Undergraduate Students to Work on Medical Cases (Preprint)

2021 ◽  
Author(s):  
Alhad Mulkalwar
Keyword(s):  
Case Report ◽  
Undergraduate Students ◽  
Formal Education ◽  
Medical Literature ◽  
Medical Problem ◽  
Evidence Based ◽  
Medical Progress ◽  
Based Medicine ◽  
Publishable Case Report

UNSTRUCTURED A case report is a detailed narrative that describes the symptoms, signs, diagnosis, treatment, and follow-up of a medical problem of an individual patient. They usually describe an unusual or novel occurrence and although they lie at the bottom of the hierarchy of the Evidence Based Medicine Pyramid, they still remain one of the cornerstones of medical progress and provide key additions to the existing medical literature. Unfortunately, abysmally few physicians-in-training receive a formal education regarding what constitutes a publishable case report. The article throws light on this aspect of medical education

Comparing Midterm Outcomes of High-Level Athletes Versus Nonathletes Undergoing Primary Hip Arthroscopy: A Propensity-Matched Comparison With Minimum 5-Year Follow-up

2021 ◽  
pp. 036354652110417
Author(s):  
Andrew E. Jimenez ◽  
Peter F. Monahan ◽  
David R. Maldonado ◽  
Benjamin R. Saks ◽  
Hari K. Ankem ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
Statistical Significance ◽  
Arthroscopic Surgery ◽  
Harris Hip Score ◽  
Control Group ◽  
Level Of Evidence ◽  
Femoroacetabular Impingement Syndrome ◽  
Patient Reported ◽  
High Level

Background: High-level athletes (HLAs) have been shown to have better short-term outcomes than nonathletes (NAs) after hip arthroscopy. Purpose: (1) To report midterm outcomes of HLAs after primary hip arthroscopy and (2) to compare their results with a propensity-matched cohort of NA patients. Study Design: Cohort study; Level of evidence, 3. Methods: Data were prospectively collected and retrospectively reviewed between February 2008 and November 2015 for HLAs (professional, college, or high school) who underwent primary hip arthroscopy in the setting of femoroacetabular impingement syndrome (FAIS). HLAs were included if they had preoperative, minimum 2-year, and minimum 5-year follow-up data for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), and Hip Outcome Score Sports-Specific Subscale (HOS-SSS). Radiographic and intraoperative findings, surgical procedures, patient-reported outcomes (PROs), patient acceptable symptomatic state (PASS), minimal clinically important difference (MCID), and return to sport were reported. The HLA study group was propensity-matched to a control group of NA patients for comparison. Results: A total 65 HLA patients (67 hips) were included in the final analysis with mean follow-up time of 74.6 ± 16.7 months. HLAs showed significant improvement in all PROs recorded, achieved high rates of MCID and PASS for mHHS (74.6% and 79.4%, respectively) and HOS-SSS (67.7% and 66.1%, respectively), and returned to sport at high rates (80.4%). When compared with the propensity-matched NA control group, HLAs reported higher baseline but comparable postoperative scores for the mHHS and NAHS. HLA patients achieved MCID and PASS for mHHS at similar rates as NA patients, but the HLA patients achieved PASS for HOS-SSS at higher rates that trended toward statistical significance (66.1% vs 48.4%; P = .07). NA patients underwent revision arthroscopic surgery at similar rates as HLA patients (14.9% vs 9.0%, respectively; P = .424). Conclusion: Primary hip arthroscopy results in favorable midterm outcomes in HLAs. When compared with a propensity-matched NA control group, HLAs demonstrated a tendency toward higher rates of achieving PASS for HOS-SSS but similar arthroscopic revision rates at minimum 5-year follow-up.

scholarly journals The Use of a Synthetic Cartilage Implant for Hallux Rigidus

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0045
Author(s):  
Niall Smyth ◽  
Jonathan Kaplan ◽  
Amiethab Aiyer
Keyword(s):  
Polyvinyl Alcohol ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Hallux Rigidus ◽  
Reference List ◽  
Great Toe ◽  
Level Of Evidence ◽  
High Level ◽  
Ability Measure

Category: Other Introduction/Purpose: Hallux rigidus is one of the most common pathologies afflicting the foot. Various joint salvage techniques have been described with a multitude of different implants. Recently, a synthetic cartilage implant composed of polyvinyl alcohol (PVA) received FDA premarket approval for treatment of arthritis of the great toe and has been used in over 4,000 cases. The purpose of this study was to systematically review the clinical evidence supporting the use of a PVA implant in hallux rigidus. Methods: A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Using the terms “cartiva OR polyvinyl alcohol OR synthetic cartilage OR hemiarthroplasty AND hallux rigidus OR great toe arthritis OR first toe arthritis “ we searched the PubMed/Medline database in December 2017. In addition, the reference list of publications were scanned for further relevant studies. Results: 4 studies met the inclusion criteria, all of which were derived from a single randomized controlled trial. At short-term follow-up (2 years), patients undergoing placement of a PVA implant had significant improvement in Foot and Ankle Ability Measure (FAAM) sports and activity of daily living, as well as VAS pain scores. The outcomes of the surgery were found to be noninferior compared to arthrodesis. At intermediate follow-up (5 years), the improvement in clinical outcomes persisted and implant survivorship was 96%. Conclusion: There are limited studies available detailing the outcomes of a PVA implant for hallux rigidus, however the results that are available demonstrate a high level of evidence. There are no long-term publications assessing the outcomes of a PVA implant for hallux rigidus.

Are Guidelines Important? Results of a Prospective Quality Improvement Lumbar Fusion Project

Neurosurgery ◽  
2021 ◽  
Author(s):  
James Harrop ◽  
Alexandra Emes ◽  
Ameet Chitale ◽  
Chengyuan Wu ◽  
Fadi Al Saiegh ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Odds Ratio ◽  
Lumbar Fusion ◽  
Evidence Based ◽  
Multiple Logistic Regression ◽  
Surgical Indications ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Based Medicine

Abstract BACKGROUND United States (U.S.) healthcare is a volume-based inefficient delivery system. Value requires the consideration of quality, which is lacking in most healthcare disciplines. OBJECTIVE To assess whether patients who met specific evidence-based medicine (EBM)-based criteria preoperatively for lumbar fusion would achieve higher rates of achieving the minimal clinical important difference (MCID) than those who did not meet the EBM indications. METHODS All elective lumbar fusion cases, March 2018 to August 2019, were prospectively evaluated and categorized based on EBM guidelines for surgical indications. The MCID was defined as a reduction of ≥5 points in Oswestry Disability Index (ODI). Multiple logistic regression identified multivariable-adjusted odds ratio of EBM concordance. RESULTS A total of 325 lumbar fusion patients were entered with 6-mo follow-up data available for 309 patients (95%). The median preoperative ODI score was 24.4 with median 6-mo improvement of 7.0 points (P &lt; .0001). Based on ODI scores, 79.6% (246/309) improved, 3.8% (12/309) had no change, and 16% (51/309) worsened. A total of 191 patients had ODI improvement reaching the MCID. 93.2% (288/309) cases were EBM concordant, while 6.7% (21/309) were not. In multivariate analysis, EBM concordance (P = .0338), lower preoperative ODI (P &lt; .001), lower ASA (American Society of Anesthesiologists) (P = .0056), and primary surgeries (P = .0004) were significantly associated with improved functional outcome. EBM concordance conferred a 3.04 (95% CI 1.10-8.40) times greater odds of achieving MCID in ODI at 6 mo (P = .0322), adjusting for other factors. CONCLUSION This analysis provides validation of EBM guideline criteria to establish optimal patient outcomes. The EBM concordant patients had a greater than 3 times improved outcome compared to those not meeting EBM fusion criteria.

scholarly journals An evidence-based review of hyperbaric oxygen for children with cerebral palsy

2001 ◽  
Vol 57 (4) ◽  
pp. 21-22
Author(s):  
F. M. Bischof
Keyword(s):  
Cerebral Palsy ◽  
Pilot Study ◽  
Motor Function ◽  
Controlled Trial ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Children With Cerebral Palsy ◽  
High Level

This paper reviews the evidence in the literature for the use of hypebaric oxygen (HBO) in the treatment of cerebral palsy (CP). To date there are only two published studies on the outcome of HBO administration in CP. A pilot study showed significant improvement in gross motor function but provided a low level of evidence. A recent multicentre, double blind, placebo controlled trial reported similar improvements in both HBO and placebo groups, but no difference between the groups. This study had a high level of evidence. The results suggest that participation in the trial produced clinically important gains in function. The outcome of the study implies that HBO may have a placebo effect in CP.

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