Ultrasound patterns of different dermal filler materials used in aesthetics.

Background Hyaluronic acid (HA) injection procedures has experienced an unprecedented increase. Aims To assess and determine, by using ultrasound examinations, the patterns corresponding to different dermal fillers. Patients/Methods Observational and retrospective bicenter study conducted on patients who underwent previous aesthetic treatments with dermal fillers. Ultrasound examinations were performed, at each study center, by one experienced observer. Results Sixty patients were included in the analysis. Among them, 48 patients showed a well-defined ultrasound pattern, while 12 exhibited a mixed one. According to ultrasound images, 4 different patterns were identified: [1] Heterogeneous, characterized by alternating hyperechoic and anechoic areas, which are visualized in the tissue in a heterogeneous way. This pattern is associated with healthy skin/subcutaneous cellular tissue and with fully integrated HA fillers. [2] Fine grain snowfall, characterized by alternating hyperechoic imaging, with posterior echogenic shadows. It is typical of liquid injectable silicone. [3] Coarse grain snowfall, characterized by hyperechoic images distributed all over the tissue. This is typical of calcium hydroxyapatite and polymethyl methacrylate-based fillers. [4] Globular, typical "cystic" imaging, with anechoic images indicative of liquid semi-liquid content. This pattern is characteristic of polyalkylamides and polyacrylamides, and HA-based fillers immediately after their injection. The presence of "mixed" patterns is mainly due to different aesthetic procedures performed at different times. Conclusions Ultrasound imaging may be a valuable tool for assessing the nature of former dermal filler procedures in daily practice. The identification of these patterns will allow specialists to choose the best therapeutic approach in patients who underwent previous aesthetictreatments.

Dairy product consumption and risk of type 2 diabetes in an elderly Spanish Mediterranean population at high cardiovascular risk.

PURPOSE: The possible effects of dairy consumption on diabetes prevention remain controversial. The aim of this study was to investigate the association between the dairy consumption and type 2 diabetes (T2D) risk in an elderly Mediterranean population at high cardiovascular risk. METHODS: We prospectively followed 3,454 non-diabetic individuals from the PREDIMED study. Dairy consumption was assessed at baseline and yearly using food frequency questionnaires and categorized into total, low-fat, whole-fat, and subgroups: milk, yogurt, cheeses, fermented dairy, concentrated full fat, and processed dairy. Hazard ratios (HRs) were calculated using Cox proportional hazards regression models. RESULTS: During a median follow-up of 4.1 years, we documented 270 incident T2D cases. After multivariate adjustment, total dairy product consumption was inversely associated with T2D risk [0.68 (95% CI 0.47-0.98); P-trend = .040]. This association appeared to be mainly attributed to low-fat dairy; the multivariate HRs (95% CIs) comparing the highest versus the lowest tertile consumption were 0.65 (0.45-0.94) for low-fat dairy products and 0.67 (0.46-0.95) for low-fat milk (both P-trend <.05). Total yogurt consumption was associated with a lower T2D risk [HR 0.60 (0.42-0.86); P-trend = .002]. An increased consumption of total low-fat dairy and total yogurt during the follow-up was inversely associated with T2D; HRs were 0.50 (0.29-0.85), 0.44 (0.26-0.75), and 0.55 (0.33-0.93), respectively. Substituting one serving/day of a combination of biscuits and chocolate and whole grain biscuits and homemade pastries for one serving/day of yogurt was associated with a 40 and 45% lower risk of T2D, respectively. No significant associations were found for the other dairy subgroups (cheese, concentrated full fat, and processed dairy products). CONCLUSIONS: A healthy dietary pattern incorporating a high consumption of dairy products and particularly yogurt may be protective against T2D in older adults at high cardiovascular risk.

Toolkit on social participation: methods and techniques for ensuring the social participation of Roma populations and other social groups in the design, implementation, monitoring and evaluation of policies and programmes to improve their health

The toolkit on social participation was developed to help various stakeholders to promote social participation in the design, implementation, monitoring and evaluation of strategies, programmes and/or activities to improve the health of the population. This document is intended for use by policy-makers, project coordinators, professionals and nongovernmental organizations involved in promoting social participation of the general population, including Roma and other social groups (with the understanding that social participation processes must explicitly include Roma, but not exclusively). The toolkit comprises a detailed list of methods and techniques (tools) for promoting social participation throughout the policy process, providing examples and case studies mainly based on experiences of promoting social participation of Roma populations in Europe.