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BACKGROUND: Several recent observational studies have associated obesity, lifestyle factors (smoking, sleep duration, and alcohol drinking), and glycemic traits with facial aging. However, whether this relationship is causal due to confounding and reverse causation is yet to be substantiated. AIMS: We aimed to assess these relationships using Mendelian randomization (MR). METHODS: For the instrumental variables, this paper selected independent single nucleotide polymorphisms (SNPs) linked to the exposures at a genome-wide state (P < 5 × 10-8) in equivalent genome-wide association studies (GWAS). Using the UK Biobank, we obtained summary-level data for facial aging on 423,999 individuals. The primary assessments were performed through the combination of complementing techniques (simple method approaches, weighted model, MR-Egger, and weighted median) and the inverse-variance-weighted method. Along with that, we examined the heterogeneity and horizontal pleiotropy through different types of sensitivity analyses. RESULTS: The correlations were (a) facial aging for body mass index (BMI, OR = 1.054, 95% CI 1.044-1.64), (b) waist/hip ratio (OR = 1.056, 95% CI 1.023-1.091), and (c) smoking (OR = 1.023, 95% CI 1.007-1.039). Equally important, the correlations for waist/hip ratio remained robust after adjusting for the genetically predicted BMI (OR = 1.028, 95% CI 1.003-1.054). However, no causal effects of alcoholic drinking, glycemic traits, and sleep duration on facial aging were observed. CONCLUSIONS: The outcomes shed light on the potential correlation of obesity and cigarette smoking with facial aging while putting forward a more comprehensive and credible foundation for the optimization of facial aging strategies. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Estudo de Associação Genômica Ampla , Análise da Randomização Mendeliana , Animais , Humanos , Estilo de Vida , Envelhecimento , Obesidade/epidemiologia , Obesidade/genéticaRESUMO
BACKGROUND: Laser and intense pulsed light (IPL) therapies have shown promising effects on pathological scars, but the comparative effectiveness of laser and IPL therapies has not yet been studied. OBJECTIVES: The aim of this study was to compare and rank the efficacy of laser and IPL therapies to determine the most effective treatment method for pathological scars. METHODS: Relevant studies published up to February 2022 were identified by searching PubMed, Web of Science, Cochrane Library, CNKI, and Wanfang databases. We defined Vancouver Scar Scale score as the primary outcome. Both frequentist and Bayesian approaches were used to perform a network meta-analysis. RESULTS: We included 25 trials with a total of 1688 participants. The rankings based on the surface under the cumulative ranking curve for the Vancouver Scar Scale score based on the Bayesian approach suggested IPLâ +â CO2 (96.43%)â >â pulsed dye laser (PDL)â +â 1064-nm Nd:YAG (yttrium aluminum garnet) laser (86.21%)â >â PDLâ +â CO2 (82.15%)â >â CO2 (58.97%)â >â 1064-nm Nd:YAG (57.03%)â >â PDL (52%)â >â 532-nm Nd:YAG (33.28%)â >â Er:YAGâ +â IPL (28.38%)â >â Er:YAG (26.56%)â >â IPL (15.03%)â >â control (13.97%). The ranking results based on the frequentist approach were basically consistent with those based on the Bayesian approach. CONCLUSIONS: The results of the network meta-analysis showed that the combination of IPL and CO2 laser has the highest probability of being the most effective intervention. However, our conclusions must be interpreted with caution due to the relatively few evaluation indicators included in our study. Future well-designed randomized controlled trials with large sample sizes are required to confirm our conclusions.
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Lasers de Corante , Lasers de Estado Sólido , Alumínio , Teorema de Bayes , Dióxido de Carbono , Cicatriz/etiologia , Cicatriz/terapia , Humanos , Lasers de Estado Sólido/uso terapêutico , Metanálise em Rede , Resultado do Tratamento , ÍtrioRESUMO
OBJECTIVE: To evaluate the effectiveness of electric stimulation (ES) for diabetic foot ulcer (DFU) treatment. METHODS: The authors searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases for randomized clinical trials published through March 2019 that compared the efficacy of ES and standard wound care (SWC) versus SWC alone for DFU treatment. The outcomes were pooled using a random-effects model. RESULTS: Of the 145 randomized clinical trials initially identified, seven studies (with a total of 274 patients) met the inclusion criteria. The percentage decrease in ulcer area at 4 weeks was significantly greater in patients treated with ES and SWC than SWC alone (standardized mean difference, 1.09; 95% confidence interval, 0.62-1.57; P < .001). The ulcer healing rate at 12 weeks was also significantly faster in the ES group (risk difference, 0.19; 95% confidence interval, 0.06-0.32; P = .005). Subgroup analysis showed comparable efficacies with different waveforms (monophasic vs biphasic). CONCLUSIONS: Electrical stimulation appears to be an effective adjunctive therapy for accelerating DFU healing.
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Diabetes Mellitus/terapia , Pé Diabético/terapia , Terapia por Estimulação Elétrica/métodos , Cicatrização/fisiologia , Terapia Combinada , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do TratamentoRESUMO
BACKGROUND: Prefabricated flap is an important technique to reconstruct massive face and neck skin defects. But its vascularization remains unpredictable and often leads to abnormal blood supply of the harvested flap, even necrosis. Flap supercharging and turbo supercharging techniques are effectively used to improve flap blood supply. However, few studies have been reported on the application of these techniques in prefabricated induced expanded flaps. METHODS: From March 2008 to September 2012, 13 patients who have face and neck soft tissue defects were treated with prefabricated cervicothoracic flap. To overcome insufficient blood supply, 5 of them received additional microvascular augmentation in which the second or third perforator of the internal mammary artery (IMAP) and its venae comitantes were anastomosed to facial or superficial temporal vessels, contrary to the remaining 8 patients. The following results were compared: flap viability, hospital stay, complications, frequency of dressing change, reoperation rate, and remaining scars. RESULTS: No flap necrosis was observed in patients who received the supercharging procedure. By contrast, of the 8 patients who were not treated with supercharging technique, various degrees of flap necrosis occurred in 3 patients, 2 of whom received secondary operations. The frequency of dressing changes, the hospital stay, and hospital cost were reduced. Postoperative view showed better aesthetic restoration. CONCLUSIONS: The IMAP-supercharged cervicothoracic flap technique offers a reliable method for massive face and neck reconstruction. We recommended that the IMAP should always be preserved in the flap as a saving option for potential flap congestion or arterial insufficiency.
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Face/cirurgia , Artéria Torácica Interna/cirurgia , Pescoço/cirurgia , Retalho Perfurante/irrigação sanguínea , Procedimentos de Cirurgia Plástica/métodos , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Estudos Retrospectivos , Adulto JovemRESUMO
Guided by the medical ethics principles of "four principles plus scope," Chinese aesthetic medical practitioners have proposed some extremely valuable ethical principles combined with the construction of aesthetic medicine and the requirements of clinical practice such as the principle of general nonmaleficence, the principle of local minimal invasiveness, the principle of informed consent, and the principle of respect and confidentiality. Chinese aesthetic surgical ethics provide valuable guidance for the practice of aesthetic medicine. Adherence to the ethics of Chinese aesthetic surgery provides an essential guide for the practice of aesthetic medicine in China. These principles protect both the medical practitioner and the patient, helping them to avoid unnecessary risks and disputes and ultimately promoting the sustainable development of aesthetic medicine.
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Ética Médica , Procedimentos de Cirurgia Plástica/ética , Cirurgia Plástica/ética , China , Humanos , Consentimento Livre e Esclarecido , Estilo de Vida , Relações Médico-Paciente/éticaRESUMO
[This corrects the article DOI: 10.3389/fsurg.2023.1325832.].
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Toxinas Botulínicas Tipo A/efeitos adversos , Botulismo/induzido quimicamente , Técnicas Cosméticas/efeitos adversos , Adulto , Amifampridina/administração & dosagem , Antitoxina Botulínica/administração & dosagem , Botulismo/diagnóstico , Botulismo/terapia , Terapia Combinada/métodos , Feminino , Humanos , Injeções , Pessoa de Meia-IdadeRESUMO
Nerve regeneration conditioned fluid is secreted by nerve stumps inside a nerve regeneration chamber. A better understanding of the proteinogram of nerve regeneration conditioned fluid can provide evidence for studying the role of the microenvironment in peripheral nerve regeneration. In this study, we used cylindrical silicone tubes as the nerve regeneration chamber model for the repair of injured rat sciatic nerve. Isobaric tags for relative and absolute quantitation proteomics technology and western blot analysis confirmed that there were more than 10 complement components (complement factor I, C1q-A, C1q-B, C2, C3, C4, C5, C7, C8ß and complement factor D) in the nerve regeneration conditioned fluid and each varied at different time points. These findings suggest that all these complement components have a functional role in nerve regeneration.