Safety and patient satisfaction of abobotulinumtoxinA for aesthetic use. A systematic review

A systematic review of the published literature (from January 2000 to January 2016) to ascertain the safety of, and patient satisfaction with, the aesthetic use of abobotulinumtoxinA was conducted. In addition to the licensed indications, other special populations were considered for discussion. The potential impact of neutralizing antibodies and systemic toxicity were also addressed. A total of 364 papers were screened and 86 were found to be relevant to the population, intervention(s), and outcomes stipulated in the protocol. The safety and patient satisfaction data from these publications are discussed in this review

The use of human adipose-derived stem cells in the treatment of physiological and pathological vulvar dystrophies

“Vulvar dystrophy” is characterized by chronic alterations of vulvar trophism, occurring in both physiological (menopause) and pathological (lichen sclerosus, vulvar graft-versus-host disease) conditions. Associated symptoms are itching, burning, dyspareunia and vaginal dryness. Current treatments often do not imply a complete remission of symptoms. Adipose-Derived Stem Cells (ADSCs) injection represents a valid alternative therapy to enhance trophism and tone of dystrophic tissues. We evaluated efficacy of ADSCs-based therapy in the dystrophic areas. From February to April 2013 we enrolled 8 patients with vulvar dystrophy. A biopsy specimen was performed before and after treatment. Digital photographs were taken at baseline and during the follow-up. Pain was detected with Visual Analogue Scale and sexual function was evaluated with Female Sexual Function Index. All patients received 2 treatments in 3 months. Follow-up was at 1 week , 1 and 3 months, and 1 and 2 years. We obtained a significant vulvar trophism enhancement in all patients, who reported pain reduction and sexual function improvement. Objective exam with speculum was easy to perform after treatment. We believe ADSCs-based therapy finds its application in the treatment of vulvar dystrophies, since ADSCs could induce increased vascularization due to their angiogenic properties and tissue trophism improvement thanks to their eutrophic effect

Improvement of mouth functional disability in systemic sclerosis patients over one year in a trial of fat transplantation versus adipose-derived stromal cells

Background. Systemic sclerosis (SSc) is a multisystem disease characterized by cutaneous and visceral fibrosis. Face and mouth changes include telangiectasia, sicca syndrome, and thinning and reduction of mouth width (microcheilia) and opening (microstomia). We applied autologous fat transplantation compared with autologous adipose-derived stromal cells (ADSCs) injection to evaluate the clinical improvement of mouth opening. Methods. From February to May 2013 ten consecutive SSc patients were enrolled from the outpatient clinic of Plastic Surgery Department of Sapienza University of Rome. Patients were divided into two groups as follows: 5 patients were treated with fat transplantation and 5 patients received infiltration of ADSCs produced by cell factory of our institution. To value mouth opening, we use the Italian version of Mouth Handicap in Systemic Sclerosis Scale (IvMHISS). Mouth opening was assessed in centimetres (Maximal Mouth Opening, MMO). In order to evaluate compliance and physician and patient satisfaction, we employed a Questionnaire of Satisfaction and the Visual Analogic Scale (VAS) performed before starting study and 1 year after the last treatment. Results and Conclusion. We noticed that both procedures obtained significant results but neither one emerged as a first-choice technique. The present clinical experimentation should be regarded as a starting point for further experimental research and clinical trials

Iginio Tansini revisited

The origin of the muscolocutaneous latissimus dorsi flap dates back to 1906 when Igino Tansini, an Italian surgeon, described a procedure to reconstruct the mastectomy defect. After a detailed study of Tansini's original description and drawings, new insights about the pedicle of its compound flap have been found, showing that it has the same pedicle of the scapular flap. In the end, Tansini's flap should be more correctly considered as a compound musculocutaneous scapular flap

An improved method of supercharged transposed latissimus dorsi flap with the skin paddle for the management of a complicated lumbosacral defect

OBJECTIVE: Treatment of nonhealing wounds of lower back often poses a powerful challenge. We present one of the first report of treatment of a lumbosacral defect with a supercharged latissimus dorsi flap with the skin paddle. CASE REPORT: We report a case of a 59 yearold man with myeloma of the sacral spine who underwent radiotherapy and chemotherapy and subsequently, laminectomies and placement of hardware for ongoing paresis and spine instability. Then, he developed an open wound and osteomyelitis of the spine with culture positive tuberculous granulomas. After multiple surgical debridement, he presented to our service and was treated with a single stage debridement followed by the performance of a latissimus dorsi musculocutaneous flap based on paraspinal perforators and supercharged. RESULTS: This solution, allowed for augmentation of blood flow to the muscle with the inferior gluteal artery, provided coverage of the defect resistant to the pressure, and simplified post-operative management of the patient. CONCLUSIONS: Alternative treatment options, including free tissue transfer, posed difficulties in finding suitable recipient vessels near the defect, in inserting the flap so as to restore its original length without compromising blood flow, and in postoperative care of the patient. Treatment of a lumbosacral defect with a supercharged latissimus dorsi flap with the skin paddle may represent a milestone procedure for complicated lower spine wounds

Thoracic migration of silicone gel after breast implant rupture: a case report and literature review

AbstractNowadays silicone is a widespread material for medical devices. In particular, it is commonly used for implants manufacturing, for that patients undergoing breast augmentation or breast reconstruction after mastectomy. However, the use of silicone implants is not free from risks. Ruptures of silicone breast implants are uncommon, in general post-traumatic or iatrogenic, and usually related to implant's wall weakness of unknown origin but probably due to biochemical reactions that cause wall rupture. As a consequence of a rupture, silicone gel from damaged implants may have a continuity migration to the chest wall, axillae, and upper extremities, resulting in granulomatous inflammation or siliconoma, or a lymphatic migration to axillary lymph nodes. In this regard, silicone thoracic migration is extremely rare, and nowadays a leakage is unlikely to happen with more modern cohesive silicone gel implants. Nevertheless, procedures such as thoracic surgery and thoracotomies may be responsible for accidental breast implant rupture, capsular discontinuity, and eventually intrathoracic silicone migration, especially when dealing with older generations of breast implants. We report a rare case of a 75-year-old woman presenting with pleural silicone effusion, 18 years after a right breast reconstruction for breast cancer, followed by right upper lobe resection for a lung carcinoma. A combination of muscular flap and DTI pre-pectoral breast reconstruction with biological membrane (ADM) has been used for treatment. Literature was reviewed for cases of breast implants free silicone localization in the chest cavity, focusing on previous surgeries, anamnestic relevances, and surgical management.Level of Evidence: Level V, risk/prognostic study

The Online Observation Quality System for the ASTRI Mini-Array

The ASTRI Mini-Array is an international collaboration led by the Italian National Institute for Astrophysics (INAF), aiming to construct and operate an array of nine Imaging Atmospheric Cherenkov Telescopes (IACTs) to study gamma-ray sources at very high energy (TeV) and to perform stellar intensity interferometry observations. This contribution describes the design and the technologies used by the ASTRI team to implement the Online Observation Quality System (OOQS). The main objective of the OOQS is to perform data quality analyses in real-time during Cherenkov and intensity interferometry observations to provide feedback to both the Central Control System and the Operator. The OOQS performs the analysis of key data quality parameters and can generate alarms to other sub-systems for a fast reaction to solve critical conditions. The results from the data quality analyses are saved into the Quality Archive for further investigations. The Operator can visualise the OOQS results through the Operator Human Machine Interface as soon as they are produced. The main challenge addressed by the OOQS design is to perform online data quality checks on the data streams produced by nine telescopes, acquired by the Array Data Acquisition System and forwarded to the OOQS. In the current OOQS design, the Redis in-memory database manages the data throughput generated by the telescopes, and the Slurm workload scheduler executes in parallel the high number of data quality analyses.Comment: 8 pages, 3 figures, Proceedings of the 37th International Cosmic Ray Conference (ICRC 2021), Berlin, German

ASTRI Mini-Array Top Level Software Architecture

This document provides a comprehensive architectural overview of the ASTRI Mini-Array Software system (a.k.a MA Software or MA Software System), which manages observing projects, observation handling, array control and monitoring, data acquisition, archiving, processing and simulations of the Cherenkov and Intensity Interferometry observations, including science tools for the scientific exploitation of the ASTRI MA data. This document, using a number of different views, depicts different aspects of the Mini-Array software and describes the significant architectural decisions

The Software Architecture and development approach for the ASTRI Mini-Array gamma-ray air-Cherenkov experiment at the Observatorio del Teide

The ASTRI Mini-Array is an international collaboration led by the Italian National Institute for Astrophysics (INAF) and devoted to the imaging of atmospheric Cherenkov light for very-high gamma-ray astronomy. The project is deploying an array of 9 telescopes sensitive above 1 TeV. In this contribution, we present the architecture of the software that covers the entire life cycle of the observatory, from scheduling to remote operations and data dissemination. The high-speed networking connection available between the observatory site, at the Canary Islands, and the Data Center in Rome allows for ready data availability for stereo triggering and data processing

ASTRI Mini-Array core science at the Observatorio del Teide

The ASTRI (Astrofisica con Specchi a Tecnologia Replicante Italiana) Project led by the Italian National Institute for Astrophysics (INAF) is developing and will deploy at the Observatorio del Teide a mini-array (ASTRI Mini-Array) composed of nine telescopes similar to the small-size dual-mirror Schwarzschild-Couder telescope (ASTRI-Horn) currently operating on the slopes of Mt. Etna in Sicily. The ASTRI Mini-Array will surpass the current Cherenkov telescope array differential sensitivity above a few tera-electronvolt (TeV), extending the energy band well above hundreds of TeV. This will allow us to explore a new window of the electromagnetic spectrum, by convolving the sensitivity performance with excellent angular and energy resolution figures. In this paper we describe the Core Science that we will address during the first four years of operation, providing examples of the breakthrough results that we will obtain when dealing with current open questions, such as the acceleration of cosmic rays, cosmology and fundamental physics and the new window, for the TeV energy band, of the time-domain astrophysics