Statements on the Safety of Permanent Soft Tissue Fillers in Europe

Increasing reported complications associated with permanent soft tissue fillers have led the national medical societies and governmental institutes in Europe to send out warnings regarding their use. Regulation and legislation for the introduction of new products and the use of existing products are necessary to guarantee patient safety

Skin measurement devices to assess skin quality: A systematic review on reliability and validity

Background: Many treatments aim to slow down or reverse the visible signs of skin aging and thereby improve skin quality. Measurement devices are frequently employed to measure the effects of these treatments to improve skin quality, for example, skin elasticity, color, and texture. However, it remains unknown which of these devices is most reliable and valid. Materials and methods: MEDLINE, Embase, Cochrane Central, Web of Science, and Google Scholar databases were searched. Instruments were scored on reporting construct validity by means of convergent validity, interobserver, intraobserver, and interinstrument reliability. Results: For the evaluation of skin color, 11 studies were included describing 16 measurement devices, analyzing 3172 subjects. The most reliable device for skin color assessment is the Minolta Chromameter CR-300 due to good interobserver, intraobserver, and interinstrument reliability. For skin elasticity, seven studies assessed nine types of devices analyzing 290 subjects in total. No intra and interobserver reliability was reported. Skin texture was assessed in two studies evaluating 72 subjects using three different types of measurement devices. The PRIMOS device reported excellent intra and interobserver reliability. None of the included reviewed devices could be determined to be valid based on construct validity. Conclusion: The most reliable devices to evaluate skin color and texture in ordinary skin were, respectively, the Minolta Chromameter and PRIMOS. No reliable device is available to measure skin elasticity in ordinary skin and none of the included devices could be determined to be designated as valid

Phalangeal fractures of the hand:An analysis of gender and age-related incidence and aetiology

The incidence and aetiology of 6,857 phalangeal fractures of the hand have been reviewed in a series of 235,427 patients, looking for an age-specific vulnerability to fracture. We found sports to be the main cause of fracture in the 10-29 years age groups and accidental falls to be the leading cause in those aged 70 years or older. We made a new observation that the highest incidence occurs in the male 40-69 age group and machinery was the dominant cause of fracture in this group. Recognition of the frequency of industrial trauma is needed, and public expenditure should be invested in its prevention and treatment.</p

Conservative treatment of CMC-1 osteoarthritis

Initially, osteoarthritis of the carpometacarpal joint of the thumb (CMC-1) should be conservatively treated. However, literature concerning this topic is absent. Therefore, 39 patients (71 hands) with conservatively treated osteoarthritis of the carpometacarpal joint of the thumb were reviewed. The minimum follow-up period was I year; the average follow-up period was 8.8 years. Thirty-two women had bilateral CMC-I osteoarthritis; the remaining seven patients had unilateral CMC-1 osteoarthritis. Although suggested by others, long-term pain relief was not observed in this study. Moreover, patient satisfaction, thumb strength, and mobility were not influenced by the duration of the CMC-1 osteoarthritis. In conservatively treated patients, worse results are achieved than in operated patients, especially concerning their subjective experiences. The authors therefore advise surgery, especially in the case of pain which hampers the activities of daily life

The BAPRAS screening tool for reimbursement in a postbariatric population

Introduction: Reimbursement of body-contouring surgery (BCS) is a worldwide problem: there is no objective instrument to decide which postbariatric patients should qualify for reimbursement. The British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) has developed a screening tool for this purpose. In this study, we used a modified version of this screening tool in a postbariatric population and describe which patients would qualify for reimbursement using this tool. Methods: In this cross-sectional study postbariatric patients were asked to fill in an online questionnaire based on the BAPRAS screening tool with questions regarding complaints of overhanging skin and medical history. Weight loss data were extracted from a prospective database. The BODY-Q was added to assess patient-reported outcomes. Results: Patients who wanted to undergo BCS (n = 90) had higher screening tool scores and lower BODY-Q scores compared to patients who did not want BCS (n = 24). In total, 25 patients (26%) qualified for reimbursement, these patients had higher weight loss (33.5% versus 29.2%, p = 0.008), lower BMI (27.3 kg/m2 versus 30.4 kg/m2, p = 0.014) and more medical (4.0 versus 2.0, p = 0.004) and psychological complaints (88% versus 61%, p = 0.009). There was a significant, negative correlation between the screening tool scores and almost all BODY-Q scales. Conclusions: Patients with a desire for BCS have more complaints of excess skin, which negatively impacts their well-being. With the modified BAPRAS screening tool, patients with the best weight (loss) and most medical and psychological complaints of excess skin qualified for referral and reimbursement of BCS

Nonequilibrium Kondo Effect in a Multi-level Quantum Dot near singlet-triplet transition

The linear and nonlinear transport through a multi-level lateral quantum dot connected to two leads is investigated using a generalized finite-$U$ slave-boson mean field approach. For a two-level quantum dot, our calculation demonstrates a substantial conductance enhancement near the degeneracy point of the spin singlet and triplet states, a non-monotonic temperature-dependence of conductance and a sharp dip and nonzero bias maximum of the differential conductance. These agree well with recent experiment observations. This two-stage Kondo effect in an out-of-equilibrium situation is attributed to the interference between the two energy levels.Comment: 4 pages, 3 figure

The influence of a fibrin-coating inside a biodegradable poly(DL-lactide-e-caprolactone) nerve guide on peripheral nerve regeneration

The aim of this study was to evaluate the effect of a fibrin-coating on the inner surface of a biodegradable poly(DL-lactide-ε-caprolactone) nerve guide on the speed and quality of the nerve regeneration. The nerve regeneration and orientation of the nerve fibers, as well as the fibrous tissue formation were evaluated. On the short term, nerve regeneration was slightly faster in the non-coated nerve guide. After longer implantation periods (≥ 4 weeks), nerve regeneration in the fibrin-coated nerve guides was characterized by a severe inflammatory response with large numbers of macrophages and polymorphonuclear cells (PMN's). This study clearly demonstrates that nerve regeneration in a fibrin-coated nerve guide is not faster when compared with a non-coated nerve guide, and that nerve regeneration in the fibrin-coated nerve guide is even worse after longer implantation periods.</p