"Dynamic Canthopexy" Drill Hole Canthal Repositioning

Background: Canthopexies can be performed to modify the eye slant, both when the lateral canthus is lower than the medial one (congenital defect) or in case the patient asks for an almond-shaped eye (cosmetic indication).Objectives: This peculiar type of canthopexy can be defined as "dynamic canthopexy," meaning that the lateral canthus is released from its original insertion and raised to a higher position. The goal of this study is to demonstrate the differences and the efficacy of the dynamic cantoplasty.Methods: The authors reviewed 30 patients treated with a "dynamic canthopexy" between January 2005 and March 2015. Eighteen patients were affected by true downslanting palpebral fissure, and 12 patients had a normal eye shape but were wishing for a more "Asian" look. Dynamic canthopexy involves a total modification of the canthal suspension system and its careful reconstruction at a higher level inside the orbital rim. To obtain a permanent result, canthal ligament and tendon had to be anchored to drill holes in the orbital rim bone with nonabsorbable sutures. Symmetry was very carefully assessed. The average surgical time was 1 hour.Results: This surgery proved extremely effective in all cases. Patients must be warned, though, that an initial hypercorrection is necessary to achieve the desired canthal position. About 6 months after surgery the result of this operation can be considered permanent. Severe complications are rare.Conclusions: Dynamic canthopexy can provide stable correction of anti-Mongolian slant. It can also be effectively employed to obtain permanent slant eyes when required by purely cosmetic patients. If precisely carried out, this technique can yield very rewarding outcomes

Lip Reshaping with LOVE Approach:A Prospective Analysis Based on Two Hyaluronic Acid Fillers

Background:. Aesthetic improvement of the lips with hyaluronic acid fillers is a popular procedure. A comprehensive, modular, and highly individualizable method has been developed: the Lip Omnicomprehensive Volume Enhancement (LOVE) approach. The present study assessed the safety and effectiveness of LOVE across different patient age groups. Methods:. This was a prospective, single-center study of women aged 20–70 years seeking nonsurgical lip enhancement or asymmetry correction. Three equally sized groups were formed based on patient age: 20–34, 35–45, and 46 years or older. Individualized treatment plans were developed taking into account patient preferences expressed in a pre-injection questionnaire. Treatment used one or more of the three modules of LOVE: lip shape [vermilion border, Vycross (VYC)-17.5]; volume (vermilion body, VYC-17.5); and hydration (submucosal area, VYC-12). Follow-up lasted 6 months. Results:. Sixty patients were enrolled (mean age: 41.3 ± 13.3 years; n = 20 per age group), all of whom were White. Most were treated with all three LOVE modules. Mean filler quantities increased with age: 20–34 years, 1.1 ± 0.1 mL; 35–45 years, 1.5 ± 0.1 mL; 46 years or older, 1.6 mL ± 0.2 mL. Mean patient satisfaction at 4 weeks [on a seven-point scale from 0 (extremely dissatisfied) to 6 (extremely satisfied)] was 4.8–4.9 in each age group. Apart from minor and transient edema/bruising, there was only one complication: a case of lumps that resolved with home massage. Conclusion:. The LOVE approach is safe and effective across a range of ages, with high levels of patient satisfaction

Effectiveness, Longevity, and Complications of Facelift by Barbed Suture Insertion

Background Minimally invasive facelift techniques involving barbed suture insertion have become popular among patients who wish to correct facial tissue ptosis.Objectives The authors sought to determine the effectiveness, longevity, complications, and postoperative sequelae associated with facelift by means of barbed polydioxanone (PDO) threads.Methods A total of 160 consecutive patients who underwent facelift with barbed threads were evaluated retrospectively. For malar augmentation and correction of nasolabial grooves, 2 or 3 PDO threads (23 gauge) were placed per side; for treatment of mandibular lines, 2 to 4 PDO threads (21 gauge) were inserted per side.Results Immediately after suture placement and for 1 month postoperatively, patients experienced improvement in facial tissue ptosis. This aesthetic result declined noticeably by 6 months and was absent by 1 year. The overall complication rate in the early postoperative period was 34% (55 of 160 patients). Eighteen patients (11.2%) had superficial displacement of the barbed sutures, 15 (9.4%) experienced transient erythema, 10 (6.2%) had infection, 10 (6.2%) experienced skin dimpling, and 2 (1.2%) had temporary facial stiffness.Conclusions Placement of barbed threads yields instantaneous improvement in facial ptosis that is no longer apparent by 1 year. Given this transient benefit and the complication rate of 34%, we recommend limiting this procedure to patients with contraindications for more invasive facial surgery.Level of Evidence: 4</p

In vitro transcription profiling of the σS subunit of bacterial RNA polymerase: re-definition of the σS regulon and identification of σS-specific promoter sequence elements

Specific promoter recognition by bacterial RNA polymerase is mediated by σ subunits, which assemble with RNA polymerase core enzyme (E) during transcription initiation. However, σ70 (the housekeeping σ subunit) and σS (an alternative σ subunit mostly active during slow growth) recognize almost identical promoter sequences, thus raising the question of how promoter selectivity is achieved in the bacterial cell. To identify novel sequence determinants for selective promoter recognition, we performed run-off/microarray (ROMA) experiments with RNA polymerase saturated either with σ70 (Eσ70) or with σS (EσS) using the whole Escherichia coli genome as DNA template. We found that Eσ70, in the absence of any additional transcription factor, preferentially transcribes genes associated with fast growth (e.g. ribosomal operons). In contrast, EσS efficiently transcribes genes involved in stress responses, secondary metabolism as well as RNAs from intergenic regions with yet-unknown function. Promoter sequence comparison suggests that, in addition to different conservation of the −35 sequence and of the UP element, selective promoter recognition by either form of RNA polymerase can be affected by the A/T content in the −10/+1 region. Indeed, site-directed mutagenesis experiments confirmed that an A/T bias in the −10/+1 region could improve promoter recognition by EσS

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI &lt;18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school&#x2;aged children and adolescents, we report thinness (BMI &lt;2 SD below the median of the WHO growth reference) and obesity (BMI &gt;2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Applicazione di Metodologie 3D per l'analisi di reperti scheletrici umani

L’applicazione di strumenti ottici attivi quali i laser scanner 3D per l’acquisizione di dati complessivi del corpo umano si è recentemente affiancata in campo medico e forense alla tomografia computerizzata e alla risonanza magnetica (Thali et al, 2003; Kusnoto et al 2002). Contemporaneamente queste metodologie hanno aperto nuove possibilità di applicazione e di ricerca in campo antropologico (Kahler et al, 2003; Tobias, 2001). Al pari della tecnica fotogrammetrica, l’uso di questi strumenti attivi consente di rilevare dati oggettivi in maniera non invasiva, garantendo nel contempo una acquisizione del dato tridimensionale più rapida rispetto alla prima (Guidi, Beraldin, 2004). Le superfici del reperto, riprese da diverse angolazioni, vengono successivamente assemblate attraverso un processo definito da una sequenza di fasi codificate (Bernardini, Rushmeier, 2002): I allineamento delle scansioni acquisite con lo strumento, in modo da ricostruire l’esatta geometria del reperto in ambiente digitale; II fusione delle riprese digitali in un’unica superficie poligonale (prima rappresentazione digitale dell’oggetto acquisito); III modifica della superficie con eliminazione di eventuali imperfezioni presenti nel modello digitale acquisito. Nel campo della Paleoantropologia, dove sono fondamentali recupero, restauro, conservazione e catalogazione di reperti, queste nuove metodiche di scansione possono svolgere un’azione determinante in ognuna di queste fasi contribuendo anche ad un’eventuale valorizzazione del reperto sia in ambito divulgativo-museale che scientifico. Nel presente studio si sono voluti verificare limiti e possibilità offerti dalle nuove metodiche nell’analisi del reperto digitalizzato e la successiva possibilità di applicazione di tecniche utili per l’esecuzione di restauro e rilevazione metrica in ambiente digitale su reperti scheletrici umani di epoca medievale utilizzando un laser scanner 3D a triangolazione Minolta Vivid 910 (tempo di scansione 3 sec). Le principali fasi operative nella digitalizzazione dell’oggetto reale, il trattamento del dato tridimensionale e le potenzialità offerte dalle simulazioni in ambiente digitale del materiale osteologico vengono esaminate e discusse

Evolution of the treatment approach to cryolipolysis using the CoolAdvantage® applicator family: results from a retrospective database review

Background: The CoolAdvantage family of CoolSculpting applicators reduces skin tension and increases tissue contact compared with the previous CoolCore system. We assessed the impact of transitioning from CoolCore to CoolAdvantage in routine practice. Methods This was a retrospective, single-center analysis of consecutive cryolipolysis treatments conducted using the CoolSculpting procedure. Between January 2012 and January 2017, these were based on the CoolCore system; between January 2017 and July 2019, treatments used CoolAdvantage. Results A total of 253 patients were included (n = 196 female [77.5%]). Of these, 111 received treatment with CoolCore (130 treatment areas; 338 cycles) and 151 with CoolAdvantage (248 treatment areas; 723 cycles). With CoolCore, all treatments were to the abdomen (262 cycles) or flanks (76 cycles); with CoolAdvantage, treatments were to the abdomen (231 cycles), flanks (227 cycles), and many other areas, including the inner thighs (78 cycles), outer thighs (68 cycles), and back (30 cycles). The number of body areas treated per visit was higher with CoolAdvantage versus CoolCore (1.59 +/- 1.01 vs 1.14 +/- 0.34, respectively; p &lt; 0.0001), as was the mean number of treatment cycles per visit (4.63 +/- 4.30 vs 2.96 +/- 1.34; p &lt; 0.0001). There were only two significant complications: one paradoxical adipose hyperplasia (with CoolCore) and one loss of sensation (with CoolAdvantage). Conclusions Transitioning to the new CoolAdvantage applicator family had no impact on safety and led to greater versatility and increased numbers of cycles per treatment. Level of evidence: Level IV, therapeutic study

Minimal Undermining Suspension Technique (MUST): An Innovative Technique for Mini-Invasive Approach for Periocular Rejuvenation

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