ABSTRACT
INTRODUCTION: Studies have suggested that botulinum toxin A may improve skin quality, and application protocols using hyper-diluted doses of botulinum toxin (microdosing) have been studied as a way to achieve therapeutic goals without fully paralyzing the targeted muscles. OBJECTIVES: To evaluate the effects of a combined protocol utilizing both the standard dosing and the microdosing of AbobotulinumtoxinA for the improvement of skin quality, measured by objective and subjective measurements. METHODS: Thirty patients were treated with botulinum toxin using both the standard technique and the microdosing technique. Objective (Sebumeter®, Mexameter® and digital dermoscopy pictures) and subjective (Global Aesthetic Improvement Scale and a clinical scale for evaluating the quality of facial skin) measurements of the effects in the treated areas were taken to assess the efficacy of the treatment. RESULTS: Digital dermoscopy showed a marked reduction of erythema and telangiectasias. Erythema and telangiectasias improved both on objective and subjective measurements. Skin oleosity, static rhytids, papules and pustules and enlarged pores improved on subjective measurements. Patient satisfaction was high (93%) despite the high rate of adverse events (56%). CONCLUSIONS: The combined application of standard doses and microdoses of AbobotulinumtoxinA is effective in improving the overall quality of facial skin. The effects on erythema and telangiectasias suggest that it is an effective treatment option for patients with erythematotelangiectatic rosacea. When applying microdoses of botulinum toxin in the lower and mid-face, the doses and pattern of injection should be customized for each patient to reduce the occurrence of adverse events.
ABSTRACT
Introdução: O tratamento com campo eletromagnético focado de alta intensidade (HIFEM) usa ondas eletromagnéticas de baixa frequência para induzir contrações musculares, causando hipertrofia muscular e reduzindo a gordura subcutânea. Objetivo: avaliar os efeitos de um tratamento com HIFEM na celulite nos glúteos. Métodos: trinta mulheres foram recrutadas e randomizadas em 2 grupos que receberam 8 ou 12 sessões de HIFEM na região dos glúteos. A celulite foi avaliada utilizando a Cellulite Severity Scale, a Global Aesthetic Improvement Scale e um questionário de satisfação. Mudanças na composição corporal foram avaliadas com bioimpedância e medidas da circunferência do quadril. Resultados: a aparência global da região glútea das pacientes melhorou com o tratamento. Houve melhora na celulite de algumas pacientes, mas para a maioria a melhora não foi grande o suficiente para resultar em uma mudança de classificação na Cellulite Severity Scale. A satisfação foi alta e os eventos adversos foram poucos, não-graves e transitórios. Conclusão: os efeitos do tratamento com HIFEM na celulite da região glútea são sutis. Contudo, este tratamento é capaz de melhorar globalmente a aparência da região glútea, melhorando a percepção das pacientes sobre a gravidade de sua celulite
Introduction: High-intensity focused electromagnetic field treatment (HIFEM) uses low-frequency electromagnetic waves to induce supramaximal muscle contractions, causing muscle hypertrophy and reducing fat. Objective: To evaluate the effects of a HIFEM treatment for the improvement of cellulite on the buttocks. Methods: Thirty patients were divided into two groups that received eight or 12 HIFEM sessions on the buttocks for six weeks. We assessed the improvement in cellulite and the buttocks' global appearance through the Cellulite Severity Scale (CSS), the Global Aesthetic Improvement Scale (GAIS), and a satisfaction questionnaire. Changes in body composition were evaluated through bioimpedance and hip circumference measurements. Results: Patients from both groups improved the global appearance of their buttocks. Cellulite lesions of some patients improved, but for most patients, the improvement wasn't great enough to change the grade on the Cellulite Severity Scale. Patient satisfaction was high and adverse events were few, minor, and transitory. Conclusion: The effects of HIFEM on cellulite are subtle, as this treatment modality cannot address the fibrous septa that cause the depressed lesions of cellulite. Nevertheless, HIFEM procedures can improve the buttocks' global appearance, enhancing the patients' subjective perception of their cellulite.
ABSTRACT
Polycystic ovary syndrome (PCOS) is a prevalent condition in women of reproductive age. PCOS is characterized by androgen excess and chronic anovulation and associated with low-grade inflammation and metabolic comorbidities. Some trace elements have been linked to pathophysiological mechanisms of oxidative stress and inflammation in different disorders. Therefore, we conducted a systematic review and meta-analysis of the available evidence regarding trace element concentrations in PCOS. We reviewed MEDLINE and EMBASE in search of case-control, cross-sectional, and cohort studies published until September 2015. Of 183 studies identified, six were selected for systematic review. All used the Rotterdam criteria for the diagnosis of PCOS. Two studies evaluating chromium and one assessing cobalt levels did not observe differences between PCOS and controls. Another study recorded similar nickel and vanadium levels between the groups, but lower selenium concentrations in women with PCOS compared to controls. Four studies were included in the random effects model meta-analysis, for a total of 264 PCOS and 151 control women. Copper levels were found to be higher in women with PCOS than in controls [mean difference 0.12 ppm (95 % CI 0.07; 0.17 ppm); I 2 = 0 %]. Manganese [mean difference 0.04 ppm (95 % CI -0.05; 0.13 ppm); I 2 = 94.4 %] and zinc concentrations [mean difference 0.02 ppm (95 % CI -0.12; 0.16 ppm); I 2 = 92.4 %] were similar between the groups. The present results suggest a relationship between increased copper concentration and PCOS. This systematic review and meta-analysis is registered in PROSPERO under number CRD42016034036.
Subject(s)
Oxidative Stress , Polycystic Ovary Syndrome/metabolism , Trace Elements/metabolism , Adult , Female , Humans , Polycystic Ovary Syndrome/pathologyABSTRACT
The present systematic review and meta-analysis of case-control studies examines the associations between rs7903146 and rs12255372 polymorphisms of the TCF7L2 gene and PCOS. A search of the literature published until August 2014 was carried out in PubMed, Cochrane Central Register of Controlled Trials, EMBASE, and LILACS. There were no other limits except for the end date. We included observational studies with women of any age diagnosed with PCOS and healthy controls that analyzed polymorphisms rs7903146 and rs12255372. We included case-control or cross-sectional studies analyzing polymorphism rs7903146 or rs12255372 in women with PCOS and healthy controls. Eighteen studies were identified after the primary literature search and seven articles were included in the meta-analysis. All employed Rotterdam criteria for the diagnosis of PCOS. The genotypic distributions in the control groups were in agreement with Hardy-Weinberg equilibrium in all studies. The pooled population included Asian descendents (Chinese, Korean), Caucasians from southern Brazil, Tunisian, and European populations (British/Irish, Northern Finns, Greeks, Czechs), including 1,892 women with PCOS and 2,695 controls. There were no significant associations between PCOS and TCF7L2 rs7903146 or rs12255372 polymorphisms, irrespective of whether allele contrast, additive, dominant, or recessive models of inheritance were used. Furthermore, no significant associations were found after stratification for ethnicity (Asian or non-Asian). There was no significant heterogeneity between studies and no publication bias. The present results suggest that rs7903146 T allele or rs12255372 is not associated with risk for PCOS in non-Asian or Asian women. This systematic review and meta-analysis are registered in PROSPERO under number CRD42013005930.
