Onabotulinumtoxin Type-A Dosage for Upper Face Expression Lines in Males: A Systematic Review of Current Recommendations

2021 ◽  
Author(s):  
Rajat Kandhari ◽  
Al Imran ◽  
Nitin Sethi ◽  
Eqram Rahman ◽  
Afshin Mosahebi
Keyword(s):  
Botulinum Toxin Injection ◽  
Type A ◽  
Face Expression ◽  
Crow’S Feet ◽  
Cochrane Database ◽  
Aesthetic Procedure ◽  
Upper Face ◽  
Effective Doses ◽  
Male Patients ◽  
And Gender

Abstract Background Botulinum toxin injection is the most commonly performed minimally invasive aesthetic procedure in men. Despite various recommendations by experts on the use of onabotulinumtoxin type A in the literature, distinct guidelines for its use in males and females do not exist. Objectives The aim of this study was to delineate safe and effective doses for the use of onabotulinumtoxin type A in males for correction of upper facial expression lines. Methods PubMed (MEDLINE), Embase, the Cochrane database, and Google Scholar were searched from 2002 to 2019 inclusive. Three researchers independently assessed trials for inclusion, extracted data, checked for accuracy, and assessed the evidence with AGREE II. Results Average dosing recommended for the treatment of upper face expression lines was specific to glabellar frown lines, crow’s feet, and horizontal forehead lines. Changing trends and gender variation was noted in each of the studies. Six of the 11 recommendations suggest the need to alter dosing in male patients, although do not give separate recommendations. Conclusions There is an urgent need for up-to-date recommendations for the use of onabotulinumtoxin type A in upper face expression lines of male patients.

scholarly journals What is the prevalence of dyslipidemia in patients with idiopathic tinnitus?

2020 ◽  
Vol 8 (8) ◽  
pp. 2983
Author(s):  
Suleyman Erdogdu
Keyword(s):  
Blood Lipid ◽  
Control Group ◽  
Test Results ◽  
Cochlear Blood Flow ◽  
Number Of Patients ◽  
Significant Difference ◽  
Low Hdl ◽  
Training And Research ◽  
Male Patients ◽  
And Gender

Background: Dyslipidemia is a metabolic disorder that results from imbalanced and overfeeding as well as sedentary life. Elevated blood lipid levels can affect cochlear blood flow and fluidity, leading to decreased hearing and tinnitus. We aimed to determine whether there is a relationship between tinnitus and dyslipidemia by investigating the blood lipoprotein values of patients with tinnitus.Methods: The lipid profiles of the patients with idiopathic tinnitus who were selected among the patients who applied to Istanbul Haydarpaşa Numune Training and Research Hospital with the complaint of tinnitus between January 2019 and May 2020 were examined. The test results and age and gender distributions were compared with control groups without tinnitus complaints and statistical evaluation was performed.Results: Hypercholesterolemia in 42% of 6472 patients with idiopathic tinnitus, 18% low HDL, 50% high LDL, Hyperlipidemia was detected in 21%. 1942 (30%) of these patients were male; 4530 (70%) are women. The number of patients in the control group without tinnitus was 6470. Hypercholesterolemia in 49% of this group; 21% low HDL, 42% high LDL, 16% hyperlipidemia was detected. In this control group, 1950 (30%) of the patients were male and 4520 (70%) were female. Cholesterol of male and female patients with tinnutus. When the cholesterol, LDL and triglyceride values of HDL and LDL values and female and male patients in the control group were examined, a statistically significant difference was found (p <0.005). No statistically significant difference was found between HDL values of female and male patients with tinnutus and HDL values of female and male patients in the control group (P> 0.05).Conclusions: There is a statistically relationship between tinnitus and dyslipidemia. The presence of dyslipidemia is vital due to atherosclerosis caused by dyslipidemia, especially coronary artery involvement. Therefore, dyslipidemia should be treated as it causes many diseases.

scholarly journals The nasopalatine canal and its relationship with the maxillary central incisors: a cone-beam computed tomography study

2021 ◽  
Vol 10 (15) ◽  
pp. e351101522978
Author(s):  
Ana Carolina Neves Melgaço de Lima ◽  
Dominique A. Peniche ◽  
Thais M. C. Coutinho ◽  
Fábio R. Guedes ◽  
Maria Augusta Visconti ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Average Diameter ◽  
Cone Beam ◽  
Nasopalatine Canal ◽  
Gender And Age ◽  
Post Test ◽  
Male Patients ◽  
And Gender ◽  
Student’S T

Objective: To evaluate the dimensions of the nasopalatine canal (NPC) and its relationship with the maxillary central incisors (MCI) using cone-beam computed tomography (CBCT) and to determine variations in the NPC in relation to age and gender. Methods: CBCT scans from 333 patients (67% female; 35.9 ± 14.6 years) were included. The CBCT scan was analyzed to determine the length and diameter of the NPC, the distance between the NPC and the MCI, and to evaluate the morphology of the NPC. The data were analyzed using the independent Student's t-test, the Mann–Whitney and Kruskal–Wallis tests, and Dunn's post-test (p < 0.05). Results: The average diameter and length of the NPC were 2.92 ± 0.91 mm and 12.67 ± 3.32 mm, respectively. The minimum and maximum distance between the MCI and the NPC were 0.78 ± 0.42 mm and 2.56 ± 1.38 mm, respectively. The NPC of male patients was greater in length compared with the female patients (p < 0.05). The majority presented a funnel-like morphology (34.1%), followed by a cylindrical morphology (27.5%). Conclusions: There was variability in the dimensions of the NPC and its relationship with the MCI, which was influenced by gender and age.

scholarly journals Applied Anatomy for Botulinum Toxin Injection in Cosmetic Interventions

2020 ◽  
Vol 8 (4) ◽  
pp. 336-343
Author(s):  
Ayman D’Souza ◽  
Chew Lip Ng
Keyword(s):  
Botulinum Toxin ◽  
Adverse Effects ◽  
Botulinum Toxin Injection ◽  
Injection Technique ◽  
Optimal Outcome ◽  
Applied Anatomy ◽  
Non Invasive ◽  
Facial Musculature ◽  
Upper Face ◽  
Facial Anatomy

Abstract Purpose of Review To provide the reader with a clear overview of facial anatomy as it relates to injection of botulinum toxin. Recent Findings The review suggests the presentation of multiple combinations of facial musculature, with the forehead, glabellar, and nasal base areas as particular areas of variation. Differences in musculature result in different wrinkling patterns; with age, these changes first become apparent in the upper face, particularly in the forehead and glabellar area. Summary Botulinum toxin is well suited to achieve the optimal outcome: it is popular, safe, and non-invasive and presents with few adverse effects. Though limited, when adverse effects do arise these are primarily related to poor injection technique, often fuelled by poor anatomical knowledge. For clinicians to achieve the best outcomes with botulinum toxin use, an understanding of the facial muscles’ anatomy, actions, and interactions is key. This paper discusses the broad and intricate detail regarding the key target muscles of botulinum toxin, based on both literature review and cadaveric dissection carried out by the authors.

scholarly journals Associations Between the Fracture Type and Functional Outcomes After Distal Radial Fractures Treated With a Volar Locking Plate

Medicina ◽  
2013 ◽  
Vol 49 (9) ◽  
pp. 62
Author(s):  
Kęstutis Braziulis ◽  
Rytis Rimdeika ◽  
Rima Kregždytė ◽  
Šarūnas Tarasevičius
Keyword(s):  
Locking Plate ◽  
Hand Function ◽  
Linear Regression Analysis ◽  
Type A ◽  
Dash Score ◽  
Volar Locking Plate ◽  
Fracture Type ◽  
Type C ◽  
And Gender

Objective. The aim of this study to investigate the associations of fracture type, age, and gender with hand function after distal radius fractures treated with a volar locking plate at a 6-month follow-up. Material and Methods. A total of 120 patients with displaced distal radius fractures were included into the study. They were operated on using a volar locking plate system. All the fractures were classified according to the AO classification, and the patients were divided into 3 groups by the fracture type. The range of motion and grip strength were evaluated at the 6-month follow-up. Multivariate linear regression analysis was used to evaluate the associations of age, gender, and fracture type with the score of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. The DASH questionnaire was completed as an outcome measure. Results. A total of 28 patients experienced type A fractures; 70 patients, type B fractures; and 22 patients, type C fractures. No statistically significant difference regarding age and sex among the groups was observed. At 6 months after the surgery, the mean DASH score for type A, B, and C fractures was 16, 13, and 32, respectively (P=0.01). After the surgery, the radiographic parameters such as the volar tilt and the ulnar variance were significantly worse in the patients with type C fractures. Grip strength and the range of motion of the contralateral healthy hand at the 6-month follow-up were significantly better than those of the operated hand. The linear regression analysis showed that the type C fracture was the only factor significantly associated with lower DASH score. Conclusions. The patients with type C fractures treated with a volar locking plate had a worse wrist function as compared with the patients type A and B fractures at the 6-month follow-up. The postoperative hand function was significantly associated only with the type C fracture, while age and gender had no significant impact.

scholarly journals Increased DJ-1 in Urine Exosome of Korean Males with Parkinson’s Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Dong Hwan Ho ◽  
Sanghak Yi ◽  
Hyemyung Seo ◽  
Ilhong Son ◽  
Wongi Seol
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dependent Manner ◽  
Protein Levels ◽  
Significant Difference ◽  
Daily Dose ◽  
Male Patients ◽  
And Gender ◽  
Urine Exosomes ◽  
Potential Use

Parkinson’s disease (PD) is a difficult disease to diagnose although it is the second most common neurodegenerative disease. Recent studies show that exosome isolated from urine contains LRRK2 or DJ-1, proteins whose mutations cause PD. To investigate a potential use for urine exosomes as a tool for PD diagnosis, we compared levels of LRRK2,α-synuclein, and DJ-1 in urine exosomes isolated from Korean PD patients and non-PD controls. LRRK2 and DJ-1, but notα-synuclein, were detected in the urine exosome samples, as reported previously. We initially could not detect any significant difference in these protein levels between the patient and the control groups. However, when age, disease duration, L-dopa daily dose, and gender were considered as analytical parameters, LRRK2 and DJ-1 protein levels showed clear gender-dependent differences. In addition, DJ-1 level was significantly higher (1.7-fold) in male patients with PD than that in male non-PD controls and increased in an age-dependent manner in male patients with PD. Our observation might provide a clue to lead to a novel biomarker for PD diagnosis, at least in males.

scholarly journals Neuroactive Steroids in First-Episode Psychosis: A Role for Progesterone?

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Martino Belvederi Murri ◽  
Flaminia Fanelli ◽  
Uberto Pagotto ◽  
Elena Bonora ◽  
Federico Triolo ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Serum Levels ◽  
First Episode Psychosis ◽  
Neuroactive Steroids ◽  
First Episode ◽  
Positive Symptoms ◽  
Symptom Dimensions ◽  
Episode Psychosis ◽  
Male Patients ◽  
And Gender

Neuroactive steroids may play a role in the pathophysiology of psychotic disorders, but few studies examined this issue. We compared serum levels of cortisol, testosterone, dehydroepiandrosterone, and progesterone between a representative sample of first-episode psychosis (FEP) patients and age- and gender-matched healthy subjects. Furthermore, we analyzed the associations between neuroactive steroids levels and the severity of psychotic symptom dimensions. Male patients had lower levels of progesterone than controls (p=0.03). Progesterone levels were inversely associated with the severity of positive symptoms (p=0.007). Consistent with preclinical findings, results suggest that progesterone might have a role in the pathophysiology of psychotic disorders.

scholarly journals Gender and functional outcomes in prestroke depressive patients treated with thrombolytic therapy

2020 ◽  
Vol 15 (2) ◽  
pp. FNL46
Author(s):  
Mandy J Tate ◽  
Rachel M Shugart ◽  
Robyn A Moraney ◽  
Leanne E Brechtel ◽  
Brice Blum
Keyword(s):  
Scale Score ◽  
Functional Outcomes ◽  
Binary Logistic Regression ◽  
Recombinant Tissue Plasminogen Activator ◽  
Lower Serum ◽  
Factors Associated ◽  
Tissue Plasminogen ◽  
Male Patients ◽  
And Gender ◽  
Depressive Patients

Aim: This study investigated the clinical factors associated with functional ambulatory outcomes and gender differences in prestroke depressive patients. Materials & methods: Clinical risk factors associated with improved functional outcomes with recombinant tissue plasminogen activator-treated cohorts were determined using binary logistic regression. Results: In the adjusted analysis, improvement in ambulation was associated with male patients that had higher National Institute of Health stroke scale score (p = 0.04), a stroke history (p = 0.026), lower serum creatinine levels (p = 0.049) and were taking cholesterol reducing medication (p = 0.014). Improvement in females was associated with taking antidepressants (p = 0.027) and having lower National Institute of Health stroke scale score (p = 0.002). Conclusion: Our findings indicate gender disparities between male and female prestroke depressive patients.

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