UK esthetics associations: A robust safety net or credibility accessories?

BACKGROUND: Currently, safe practice in the UK esthetics industry is largely reliant on self-regulatory bodies. If these bodies do not maintain high standards of safety guidelines and properly accredit practitioners, patient safety may be at risk. To our knowledge, no studies have addressed cosmetic self-regulatory bodies and their websites on Google, the most commonly used information source. This study aimed to map self-regulatory bodies on Google and evaluate their roles in the current UK esthetics industry. METHOD: We conducted a systematic search of Google Search results using eight search terms. The first 100 search results were screened against our eligibility criteria. We searched each website of a self-regulatory body for their requirements to join registers, membership fees, and features listed on the UK government's criteria for an effective self-regulatory body. RESULTS: We identified 22 self-regulating bodies for the UK esthetics industry. Only 15% of registers required an in-person assessment of cosmetic skills to qualify for membership. Of the self-regulatory bodies, 65% did not set clear standards and guidelines for practice. No qualifications were required by 14% of surgical and 31% of non-surgical bodies. The mean membership fee was £331. CONCLUSION: This study uncovered important information about the self-regulation of the esthetics industry in the UK. A significant majority of self-regulatory bodies did not meet best practices, potentially putting patients at risk. We recommend further studies screening a higher number of pages in a Google Search to scope all other existing self-regulatory bodies, due to the creation of Google "filter bubbles."

Waldenström's macroglobulinemia and myasthenia gravis.

Until now, three patients with IgG and only one with IgM class monoclonal gammopathy (without the classical features of Waldenström's macroglobulinemia) have been reported in subjects with myasthenia gravis. A case of Waldenström's macroglobulinemia which occurred before thymectomy in a myasthenic patient is described in this paper. Both neuromuscular disease and the lymphocyte dyscrasia worsened after operation and before starting steroid treatment. No evidence of circulating immune complexes nor of anti-acetylcholine receptor antibodies belonging to the IgM class was found. The patient's HLA type shared A2 and B15 antigens with an IgG-lambda monoclonal gammopathy previously reported in a myasthenic woman, and his genotype included the Bw15 specificity which has been described to be frequent in Waldenström's macroglobulinemia. It appears that a persistent thymic abnormality, responsible for myasthenia gravis, may be associated with a lymphoreticular neoplasm.

Circulating immune complexes in myasthenia gravis: a study in relation to thymectomy, clinical severity and thymus histology.

Circulating immune complexes were assayed employing the method recently described by Barnett and Chia in a group of patients with myasthenia gravis. The subjects were classified according to clinical severity and immune complexes were sought before and after thymectomy. The operated subjects were further divided into those with thymoma or thymic hyperplasia. Antigen-antibody complexes were higher before thymectomy than after, in hyperplasias than in thymomas, and in severe myasthenia gravis than in mild disease. Circulating immune complexes and anti-acetylcholine receptor antibodies did not correlate.

Lack of effect of the Ca2+ ionophore A23187 on tumour cells.

The Ca2+ ionophore A23187 increases intracellular calcium content in normal thymic cells, while it is without effect on the corresponding neoplastic cell (Ascites thymoma) and on Ehrlich ascites tumour cells. The A23187-induced total cell calcium increase in normal thymocytes takes place both in control and energy-depleted cells, while it is lacking in neoplastic cells. In addition the ionophore stimulates aerobic glycolysis of normal thymocytes, whereas it is ineffective on neoplastic cells. The study of intracellular calcium exchange properties reveals that in normal cells the ionophore A23187 provokes a 60% increase of the exchangeable pool together with a more significant, 4-fold enlargement of the unexchangeable pool. These effects are lacking in cancer cells. The data give rise to interesting considerations concerning the regulation and compartmentalization of calcium in neoplastic cells. The results will be also discussed in relation to the models that predict altered cell calcium metabolism as a cause of cancer cell high aerobic glycolysis and uncontrolled growth.

Further observations on calcium and other divalent cations metabolism in intact Ehrlich ascites tumour cells.

The metabolism of calcium has been investigated in the Ehrlich Ascites Tumour Cells (ATC). ATC extrude Ca2+ actively by an energy-dependent mechanism, supported by both respiration and glycolysis. Extrusion takes place even against a very steep concentration gradient (10 mM Ca2+). Cell calcium content is decreased by monovalent cations (Na+,K+ and Li+), which act independently from their metabolic effects. La3+ inhibits ATC Ca2+ extrusion whereas Ruthenium Red slightly decreases cell calcium content. The antibiotic ionophore A 23187 strongly increases ATC Ca2+ level. the metabolism of other divalent cations (Mg2+, Sr2+ and Mn2+) has been studied. Mg2+ does not show appreciable changes in the various metabolic conditions tested, while Mn2+ and Sr2+ behave quite differently from Ca2+, suggesting a different distribution of these cations in ATC. The experimental findings indicate that Ehrlich Ascites Tumour Cells regulate their calcium content by mechanisms related to plasma membranes while the size and activity of mitochondrial compartment is of minor importance.

IgD (kappa) "nonsecretory" multiple myeloma: report of a case.

A case of IgD "nonsecretory" multiple myeloma in a 46-yr-old woman is reported. Despite the presence of disseminated osteolytic lesions, both serum protein electrophoresis and serum and urine immunoelectrophoresis were normal. In addition, bone scintigraphic study was normal. Bone marrow biopsy and aspirate obtained from the left femur lytic lesion showed only myelomatous proplasmocytes; when examined by immunofluorescence with monospecifc antisera, the cytoplasm showed only the presence of delta and kappa chains, suggesting that the neoplastic plasma cells might belong to a single clone. Lymphocyte studies indicated the presence of a normal amount of both B and T cells.

Immunochemical and ultrastructural study of multiple myeloma with a heavy chain protein in the serum.

A patient with multiple myeloma had antigenically related monoclonal Fc-gamma fragments and complete IgG-kappa molecules in the serum. The urine contained only Fc-gamma fragments in the absence of Bence-Jones protein. The two distinct M-components in the serum showed electrophoretic identity but could be separated by chromatography. The simultaneous presence of complete monoclonal IgG molecules and Fc-gamma fragments, though difficult to detect, could be a frequent occurrence in multiple myeloma, and it could be defined as 'double paraproteinaemia'. A detailed ultrastructural study was performed in this case and showed fibril bundles being released from the malignant plasma cells; such fibrils could be the supramolecular organisation of the neosynthesised heavy chain fragments.

Myasthenia gravis, thymectomy, and antiacetycholine receptor antibody.

The antiacetylcholine receptor antibody was titered in the serum of 63 patients with myasthenia gravis (MG) and 20 control healthy subjects. The titer was significantly high in 92% of MG patients in contrast with none of the controls and no correlation was found with the thymus pathology and the severity of the disease. The titer decreased after thymectomy almost steadily with the improvement of the myasthenic signs. The role of the antibody in the pathogenesis of the disease is discussed.

Water and ion metabolism in placenta (III). Net movement of water, monovalent and divalent cations in slices from rabbit placenta, at different periods of gestation, incubated under metabolically favorable conditions.

Rabbit placenta slices incubated at 38 degrees C in oxygenated medium, in the presence of endogenous substrates +5 mM glucose, after a period of preincubation of 120 min at 0--1 degrees C, show a net accumulation of potassium and extrusion of water, sodium and calcium. The movement of potassium, sodium and calcium appears to be related to the rate of oxygen consumption of the slices and to be inversely proportional to the age of the tissue. The efficiency of cations movement is also dependent on the nature and composition of the incubation medium. In this respect the potassium concentration of the medium plays a major role. The movement of water, on the other hand, seems to be completely independent from both the rate of respiration and the age of the tissue. The results are discussed in terms of relation between placenta age and senescence, and efficiency of the mechanisms devoted to the cell regulation of water and ions content.

Non-Hodgkin lymphoma associated with double monoclonal immunoglobulin.

We describe an unusual case displaying the features of double monoclonal gammapathy (IgM-kappa plus IgG-lambda) associated with non-Hodgkin lymphoma (NHL). In the last years monoclonal gammapathies have been sometimes found to be associated with NHLs; it is a very peculiar occurrence the association between a different class double monoclonal gammapathy and NHL, as the case reported in this paper.

Water and ion metabolism in placenta. II. Water compartments and electrolytes in slices of rabbit placenta, at different periods of gestation, incubated at 0-1 degree C.

The movement and the distribution of water, sodium, potassium, chloride, magnesium and calcium have been studied in slices prepared from rabbit placentae at different periods of gestation, incubated in condition of depressed metabolism (0-1 degree C). In these conditions the tissue takes up water from the external medium up to a maximum of about 2.0 kg/kg d. wt., which represents 30 per cent of the initial H2O content of the fresh tissue. The extracellular compartment swells progressively and proportionally to the age of the placenta. The sodium and chloride content of the tissue increases while that of potassium decreases and their intracellular concentration reaches, after 120 min, that of the external medium. Magnesium does not show appreciable changes and calcium, too, despite its extreme variability, does not seem to undergo significant variations during the cold incubation. The results obtained show that placenta, like most of other mammalian cell systems, possesses specific metabolism-dependent mechanisms responsible for the maintenance of water distribution and ion gradients among the different tissue compartments. The characteristics and the regulation of these mechanisms are discussed in detail.

Effects of phenobarbital and 3-methylcolanthrene treatment on microsomes of Morris hepatoma 3924-A, tumour-bearing and normal rat liver.

Microsomal cytochromes and some oxidative activities were determined in normal rat liver, tumour-bearing rat liver and Morris hepatoma 3924-A. Except for a moderate lowering of cytochromes and enzymes in host livers, the relation between TPNH-cytochrome c reductase activity and cytochrome P-450 TPNH reduction, both increased by phenobarbital (PB) and decreased by 3-methylcolanthrene (3-MC) treatment, is noteworthy. In tumour cytochromes b5 and P-450 are absent and TPNH-cytochrome c reductase is unmeasurable and not induced by PB or 3-MC treatment. Aminopyrine demethylase activity, instead, is comparable with normal or host liver and it is modified by PB or 3-MC treatment in the same way, despite the microsomal enzymes pathway disorganization. Microsomal enzymatic defect selectivity in tumours may be due to a deranged microsome-linked growth control.

Calcium metabolism in intact isolated thymocytes.

Isolated rat thymocytes incubated under proper metabolic conditions extrude Ca2+ previously taken up under metabolically unfavourable conditions. The extrusion can be supported by both respiratory and glycolytic energy but glycolysis seems to be more efficient for this purpose. La3+ (50--200 micron) and the ionophore A 23187 inhibit cell Ca2+ extrusion. Ruthenium Red (1--100 micron) does not influence cell Ca2+ extrusion while it inhibits the in situ mitochondrial cation uptake. All the results are consistent with a cell regulation model of Ca2+ content in which both plasma membrane and mitochondria co-operate, acting in opposite directions, in order to decrease cytosolic Ca2+ concentration. The possibility of Na+-Ca2+ hetero-exchange participation to cell Ca2+ homeostasis regulation is also discussed.

Calcium metabolism in Ehrlich Ascites tumour cells.

Ehrlich ascites tumour cells are able, under the proper experimental conditions, to extrude a substantial amount of Ca2+ from the intracellular space. The Ca2+ extrusion mechanism, probably located at the plasma membrane level, appears to be similar to that found in red blood cells. It is energy-dependent and both respiration and glycolysis are able to drive it. The use of some inhibitors and uncouplers, besides showing that this activity is different from that linked to the mitochondrial Ca2+ pump which acts in the opposite direction, proposes some speculations on the energy compartmentation in the Ehrlich ascites tumour cells.

The behaviour of microsomal mono-electron carriers in adult and fetal liver and in placenta throughout pregnancy.

The activities and contents of microsomal mono-electron carriers (NADPH-cytochrome c reductase, NADH-cytochrome b5 reductase, cytochrome P-450 and cytochrome b5) in the liver of 160 pregnant rabbits and their response to phenobarbital (PB) administration were found to be different to that of non pregnant animals and to vary depending on the period of gestation. In fetal liver and in placenta the activities and contents of mixed function oxidase system enzymes are very low and increase from the mid-gestation up to the term of pregnancy. PB has either effect or decreases the enzyme levels. The variations of enzyme content and activity in maternal liver and the different response to PB are related to the hormonal modifications of pregnancy. The behaviour of mono-electron carriers in fetal liver can be related to the process of maturation of this organ. The effect of PB can be due to the interference of the drug with steroid metabolism. The behaviour of mixed function oxidase system enzymes in placenta can be related to the processes of maturation and ageing of organ.

The behaviour of microsomal mono-electron carriers in human placenta during late pregnancy.

The activities and the content of enzymes involved in mixed function oxidase systems (cytochromes P-450 and b5, NADPH-cytochrome c reductase and NADH cytochrome b5 reductase) in microsomes from 114 human placentae were found to increase from the 34th up to the 38th-39th week of gestation and later to decrease until the 43rd week. Such a process can be related to the following: (i) the phospholipid content of microsomal membranes; (ii) the protein synthesis possibly induced by steroids such as androstenedione and testosterone.