Exploring Patient Motivations and Impact of Asian Blepharoplasty.

To date, patient motivations for Asian blepharoplasty and the surgery's impact on quality of life have not been quantified. Here, we employed structured interviews and a web-based survey to better characterize patient motivations for Asian blepharoplasty and the impact of Asian blepharoplasty on self-reported domains of happiness, self-esteem, attractiveness, social life, and professional life. Structured interviews were conducted to inform a web-based survey regarding Asian blepharoplasty. Survey respondents used visual analog scales to rate their satisfaction with their eye shape, motivations for undergoing Asian blepharoplasty, and perceived outcomes after surgery. A total of 315 participants (mean 25.7 [18-58] years) of East or Southeast Asian descent were included. 185 participants expressed no desire for Asian blepharoplasty, 76 expressed some desire, and 54 had already undergone surgery. There were statistically significant differences regarding baseline satisfaction, perceived social limitation, and perceived professional limitations regarding eye shape (p < 0.0001). The Looking Glass Self index (comprised of media exposure, low self-esteem, and negative stereotypes related to eye shape) is negatively associated with preoperative satisfaction with eye shape (rho = -0.29, p < 0.01). The desire for social-professional advancement and the Looking Glass Self index significantly predict self-reported improvements in professional and social life, respectively (both p < 0.01). Asian blepharoplasty may be driven by functional, social, or economic patient motivations. Some patients may see Asian blepharoplasty as a potential solution for sociological concerns. These expectations should be further explored in physician-patient discussions regarding candidacy for surgery and establishing expectations for postoperative outcomes.

The safety of multi-dose vials in allergy immunotherapy.

OBJECTIVE: To prospectively evaluate the risks of vial contamination after routine clinical use of multiple-dose vials for immunotherapy. STUDY DESIGN: Prospective observational study of immunotherapy vial cultures from June 2007 to January 2008. SETTING: Tertiary care outpatient otolaryngology clinic. RESULTS: Over an 8-month period, 136 consecutive vials were cultured for aerobic and anaerobic bacteria at the 3-month expiration date after regular use in an outpatient allergy clinic and dispensation of multiple doses of injection immunotherapy from each vial. All vials had negative cultures. CONCLUSION: Immunotherapy vials are at low risk to undergo contamination in routine use. Important factors include aseptic technique, bacteriostatic agents, and expiration dating.

Risks of allergy vial contamination: comparison of mixing in-office versus under ventilation hood.

OBJECTIVE: Compare the risk of bacterial contamination of allergy immunotherapy vials prepared in-office versus those mixed under a ventilation hood. STUDY DESIGN: Prospective single-blinded study. SETTING: Tertiary otolaryngology outpatient clinic. RESULTS: Five hundred thirty-seven vials were prepared and cultured for aerobes and anaerobes over an 11-month period. Three hundred twenty vials were arbitrarily assigned to in-office preparation and 217 to under-hood preparation. A total of two positive cultures occurred in vials prepared in-office and one from under-hood preparation. Follow-up cultures of these three vials were all negative. No patients receiving injections had signs or symptoms of skin or systemic infections from the injections. CONCLUSION: Our results suggest that the risk of bacterial contamination in immunotherapy vials in both groups is rare.

Allergen vial mixing and immunotherapy: Risks of infections and vial contamination.

OBJECTIVE: To study the risks of vial contamination and infection associated with immunotherapy vial mixing and injection. STUDY DESIGN: Retrospective review of patient immunotherapy records from January 2000-June 2006. SETTING: Tertiary care outpatient otolaryngology clinic. RESULTS: Two hundred seventy-two patients were given 26,795 injections (average of 98.5 injections per patient). Three hundred ninety-nine total local reactions were reported by the subjects (1.49%; 95% CI 1.34%-1.63%). The majority (82%) of the local reactions occurred during escalation dosing. There were 23 episodes of wheezing or shortness of breath after injections (9.6 of 10,000). No patients experienced anaphylaxis. There was no documented skin or systemic infections as a result of the allergy injections. None of the patients experienced fever, discharge from the injection site, cellulitis, or required antibiotics. CONCLUSION: This review of immunotherapy records revealed no complications of infection from the preparation and administration of immunotherapy performed in an outpatient clinic.

Combined fractionated CO2 and low-power erbium:YAG laser treatments.

This article addresses the use of fractionated CO(2) laser and erbium:YAG laser for facial rejuvenation. Outcomes and limitations of these techniques are discussed, along with a stepwise summary of techniques as they are used in clinical practice. An evaluation of patient satisfaction is presented for a group of patients who underwent combined fractional CO(2) and erbium:YAG facial resurfacing.

Injectable immunotherapy: recommendations for safe allergen vial preparation in the office setting.

PURPOSE OF REVIEW: To review the proper technique for preparing allergen vials to be used in subcutaneous immunotherapy in the office setting, examine the potential for bacterial contamination during mixing and handling and associated risk factors and review the data relevant to contamination during vial mixing. RECENT FINDINGS: Existing literature on the subject of safe vial preparation suggests that the incidence of bacterial contamination of allergen vials is very low. Historically, there is no report of bacterial infection for subcutaneous immunotherapy using vials prepared in the office setting or otherwise when using the proper sterile technique. SUMMARY: In-office compounding of vials is a safe practice with literature to support continuing this practice of preparation.