A Clinical Trial Shows Improvement in Skin Collagen, Hydration, Elasticity, Wrinkles, Scalp, and Hair Condition following 12-Week Oral Intake of a Supplement Containing Hydrolysed Collagen.

Background: Hydrolysed collagen supplements are reported to fight the signs of aging and improve skin appearance, but more authoritative clinical evidence is needed to support efficacy. Aim: This randomised, double-blind, placebo-controlled study evaluated the efficacy of a supplement containing hydrolysed collagen and vitamin C (Absolute Collagen, AC) on biophysical parameters and visible signs of aging for skin, scalp, and hair, when taken daily or every 48 hours. Methods: We measured dermal collagen using confocal microscopy and high-resolution ultrasound. Hydration, elasticity, wrinkles, and clinical trichoscopy were measured in parallel to expert visual grading. Efficacy measures were recorded at baseline, week 6, and week 12. Results: Following 12 weeks daily use of the AC supplement, using confocal microscopy, we observed a significant 44.6% decrease in fragmentation vs. placebo (p < 0.01). We also measured a change in the ultrasound LEP (low echogenic pixel) ratio comparing upper and lower dermis (-9.24 vs. -7.83, respectively, p=0.05), suggesting collagen improvements occurred more in the upper dermal compartment. After 12 weeks vs. placebo, skin hydration was increased by 13.8% (p < 0.01), R2 elasticity index was increased by 22.7% (p<0.01), and Rz profilometry index was decreased by 19.6% (p < 0.01). Trichoscopy showed an average 11.0% improvement in scalp scaling and a 27.6% increase in the total number of hairs counted vs. placebo (p=n.s.). This was associated with a 31.9% increase in clinical grading score for hair healthy appearance (p < 0.01). Conclusion: The AC supplement has shown clinical benefits for skin, scalp, and hair, when used either daily or every 48 hours, over a 12-week period.

Mastopexy using de-epithelialised dermoglandular flaps: a case series for maximal volume conservation following breast implants removal.

AIMS AND OBJECTIVE: Removal of implants without replacement is often requested, and the procedure is more commonly performed today than ever before. However, the resultant loss of body image, secondary to the loss of breast volume, is not an outcome, that a patient is looking forward to. There is a lack of information on the options available to the patients following explantation. This case series presents an option of breast volume preservation and reshaping during mastopexy after breast implant removal that can be offered to selected patients. In the current case series, de-epithelialised dermoglandular flap mastopexy was used as an autologous tissue for breast reshaping and remodelling. MATERIAL AND METHODS: Since 2015, ten patients were selected for de-epithelialised dermoglandular mastopexy using wise pattern or vertical scar. Surgery was performed under general anaesthesia as a day case. A vertically oriented bipedicular dermoglandular flap was used for vertical scar mastopexy in two patients, and eight patients had Wise pattern incisions. Of these eight patients, four had superomedial and four had inferiorly based flaps for dermoglandular mastopexy and closure. All patients had a preoperative cup size D or larger. RESULTS: All patients had adequate results with an acceptable breast cup size. There was no skin breakdown, nipple loss, haematoma or infection. CONCLUSION: De-epithelialised dermoglandular flap mastopexy is a safe procedure and can be used as an option in selected patients. LEVEL OF EVIDENCE: IV.

"Breaking breast cancer news" with ethnic minority: a UK experience.

Breaking bad news is a challenge in medicine. It requires good communication skills, understanding, and empathy on the part of a clinician. Communication has both verbal and non-verbal components. The requirement for non-verbal communication varies with various diverse groups, depending upon their cultural and religious beliefs. Breaking bad news in an ethnically diverse group is complex where cultural, religious, and language barriers may exist. The National Health Service was established in 1948. Ethnic minority comprised of only 0.2% (53,000) of the total population. The health care professionals shared the same cultural backgrounds as their patients at that time. Census in 2011 indicates that the number of the ethnically diverse group has increased to 14% (2 million) in England and Wales. Eighty-six percent of the population was white British. Asians (Pakistani, Indian, Bangladeshi, and other) "groups" made up 7.5% of the population; black groups 3.4%; Chinese groups 0.7%; Arab groups 0.4%; and other groups 0.6%. This figure is expected to increase by 20%-30% in 2050. It is, therefore, important that a doctor working within the National Health Service in the UK, should be prepared to deal with patients who may have a different culture, faith, language, and set of beliefs. In this article, I have highlighted the various challenges/issues in communication with such patients, available resources, and recommendations of strategies to improve their care. Unfortunately, no one single strategy can be applied to all as each patient should be recognized individually and as such, different factors have different weightings on each consultation. It is, therefore, important that hospitals raise cultural and religious awareness so that the doctors can be more understanding toward their patients. This will not only improve the patient's experience, medical staff would also feel professionally satisfied.

Cordylobia anthropophaga: a rare surgical emergency in the UK.

A 38-year-old healthy Caucasian man presented to the surgical team with a punctured wound on the right side of his scalp. He had been on a month's holiday to Uganda and South Africa. He recalls a painful swelling progressively increasing over 2 weeks. This was associated with sharp shooting pains and swelling on the right side of the face. He sought medical opinion while on holiday. Broad spectrum oral antibiotics were advised. The condition did not settle with the treatment so he consulted his general practitioner (GP) on return. The GP referred him to the surgical team for management of a scalp wound. On examination, a live pulsating larva was seen within a painful 1.5×2 cm puncture wound on the right side of the scalp. The larva was removed. Microbiology identified the larva as Cordylobia anthropophaga. No further treatment was advised. To our knowledge, the patient remains well to date.