The impact of adverse reactions to injectable filler substances on quality of life: results from the Berlin Injectable Filler Safety (IFS) - study.

BACKGROUND: Injectable filler substances are commonly used in aesthetic medicine. Adverse reactions are rare, but may cause severe impact on quality of life (QoL). To the best of our knowledge, data on the impact of adverse reactions caused by injectable filler substances on QoL is missing. OBJECTIVE: To evaluate the impact of adverse filler reactions on the QoL. MATERIAL AND METHODS: The Injectable Filler Safety (IFS) - study is a partially population-based registry for adverse reactions due to injectable filler substances. In 2008, the Dermatology Life Quality Index (DLQI) questionnaire was added to the questionnaires of the IFS study. For this analysis, only patients with a completed DLQI were included in the analysis. RESULTS: One hundred and four patients of the IFS study were analysed. A total of 88.5% were female with an average age of 49.2 years. Here, 50.0% were treated with biodegradable and 40.4% with permanent fillers. The most common adverse reactions were nodule formation and hardening. Most patients experienced mild to moderate adverse reactions. Impact on QoL was moderate with an average of 8.9 (±8.4 SD) in patients with adverse reactions to biodegradable and 10.5 (±9.4 SD) to permanent products. However, 24.0% and 13.4% showed a large or a very large impact on QoL. CONCLUSION: Adverse reactions to injectable filler products can have a considerable impact on the QoL, comparable to severe chronic inflammatory skin diseases such as psoriasis.

[Report on 8 years' experience in prenatal diagnosis of genetic defects. I. Indications and methods]. / Erfahrungsbericht über 8 Jahre pränatale Diagnostik genetischer Defekte. I. Mitteilung: Indikationen und Methoden.

Prenatal diagnostic procedures were done following 1231 transabdominal amniocenteses in 1113 patients of a gestational age of 17.4 +/- 0.5 weeks. Partly parallel the following methods were used: 1218 estimations of alpha-fetoprotein, 903 chromosomal analyses, 89 amniofetographies, 40 fetoscopies and 7 estaminations of hormones, immunoglobulins and enzymes. Amniotic fluid could be obtained in 91.8 per cent with the first insertion of the needle, using the free-hand-needle-technique. In 8 per cent amniotic fluid samples were bloody. The amniocentesis had to be repeated in 7.6 per cent because of no growth of cells (6.3 per cent), or no amniotic fluid could be obtained (1.3 percent). In the average 14.9 +/- 8.1 metaphases were analysed and 2.9 +/- 1.1 karyogram were made. The organisation of prenatal diagnostics was explained. The indication was in 39.6 per cent the age, in 20.3 per cent the repeated risk of the birth of a fetus with trisomy 21. In 13.7 per cent there was an indication to estimate alpha-fetoprotein which was done nearly without exception for exclusion of neural tube defects. The prenatal determination of the fetal sex was necessary in 7.3 per cent in cases of X-chromosomal inheritable diseases. Previous deliveries of infants with malformation-syndrome or chromosomal trisomies like Edwards-or Patau-syndrome and radiation or chemotherapy of one of the parents were summarized under other indications (7.3 per cent). Balanced parental translocations were the indication in 1.7 per cent. Amniofetography was used in 8 per cent of the patients to exclude malformations caused by prevalent multiple factors. It was in 35 per cent the prevailing diagnostic method. The set of problems of its use was discussed. Fetoscopy (3.6 per cent) partly was an additional diagnostic procedure partly a leading method. By means of a catalogue of indications it was referred to the use of fetoscopy to visualization in prenatal diagnostics. The exclusion of genetic metabolic defects was the motive to prenatal biochemic investigations in 0.5 per cent. The prerequisites of devices and technique to prenatal diagnostics were discussed.

[The distinction of elevated alpha-fetoprotein levels in amniotic fluids for antenatal diagnosis of genetic defects]. / Zur Differenzierung erhöhter Alpha-Fetoproteinwerte im Fruchtwasser bei pränataler Diagnostik genetischer Defekte.

Among 1017 amniotic fluid samples of 831 patients were 110 cases (10,8%) cases with sanguivolent amniotic fluid in the first portion and a second clear specimen. Contrary to the trend to analyse only the second clear share, we tested both samples. 110 pregnancies are analysed. The abortion risk (1,8%) in this group and the rate of prematurity (8,1%) are not increased. Retrospectively we were able to demonstrate a fetus injury in one case. The different analysis enable us to a conclusion about the fetal risk.