High-Intensity Focused Electromagnetic Field With Synchronized Radiofrequency Achieves Superior Gluteal Muscle Contouring Than High-Intensity Focused Electromagnetic Field Procedure Alone.

Background: The high-intensity focused electromagnetic field (HIFEM) procedure is an effective method for noninvasive toning and shaping of buttocks. Objectives: To investigate and compare the efficacy of simultaneous application of HIFEM procedure with radiofrequency (RF) heating vs HIFEM standalone procedure on the buttocks. Methods: Sixty-seven subjects (21-67 years, BMI 16-34 kg/m2) were recruited and divided into two groups. Group A received simultaneous HIFEM + RF therapy, and group B received standalone HIFEM treatments. All participants underwent four 30-minute bilateral treatments on the buttocks. The MRI was used to evaluate the changes in muscle and fat thickness. Results: Data of 32 subjects from group A and 31 subjects from group B were reviewed at 1-month follow-up. On average, subjects from group A showed a 31.3% higher increase in muscle thickness, as shown in the MRI evaluation. The gluteal muscle thickness continued to grow and peaked at a 3-month follow-up, wherein 27 patients were evaluated in each group (n = 54). Group A showed on average +24.7% increase (gluteus maximus +8.5 ± 1.9 mm, medius +6.0 ± 1.1 mm, minimus +2.9 ± 0.8 mm), while group B exhibited only +15.9% increase in muscle thickness (gluteus maximus +5.2 ± 1.1 mm, medius +3.6 ± 1.0 mm, minimus +1.6 ± 0.4 mm). On average, group A showed a 35.6% higher growth in muscle thickness. Treatments were safe and comfortable with high satisfaction rates. No adverse event was reported throughout the study. Conclusions: Our results suggest that simultaneous use of HIFEM + RF is safe and significantly more effective for gluteal contouring than the HIFEM procedure alone.

Pulsed and Fractionated Techniques for Helium Plasma Energy Skin Resurfacing.

Energy-based skin rejuvenation has, like other forms of aesthetic treatments, the capability of achieving desirable end results. These end results must be balanced with the degree and duration of morbidity, which affect recovery from treatment. Renuvion skin resurfacing protocols include a free hand approach and we describe our preferred approach of pulsing and fractionating the helium plasma resurfacing energy.

High Intensity Focused Electro-Magnetic Technology (HIFEM) for Non-Invasive Buttock Lifting and Toning of Gluteal Muscles: A Multi-Center Efficacy and Safety Study

Objective: Surgical intervention has been the only method to improve the aesthetic appearance of buttocks apart from physical exercising. This study evaluates the efficacy of high intensity focused electro-magnetic (HIFEM) treatments as a non-invasive solution for improvement of buttocks through toning and lifting of gluteal muscles. Materials and Methods: A total of 75 patients (aged 22-59) were treated using a device with HIFEM technology which stimulates gluteal muscles (EMSCULPT, BTL Industries, Boston, MA). The protocol included four 30-minute treatments. Patients' weight was monitored throughout the study. Standard photographs were taken at the baseline, after the 4th treatment, and at the 1-month follow-up. Two 7-point Likert scale questionnaires were used to evaluate patients' buttock and treatment satisfaction. Total score of buttock satisfaction was calculated as a sum of all individual questions to reflect the overall perception of patients' buttocks. The level of comfort during procedures was assessed on a visual analog scale (VAS). Results: The overall buttock satisfaction score (range, 4-28) of all subjects improved from 13.1±5.7 at baseline to 18.4±5.2 after the treatment and 18.9±5.1 at follow-up. For subjects with initial buttock dissatisfaction the scores improved from 8.7±1.6 to 16.3±3.1 after the treatment and to 17.3±3.1 at follow-up. The average score of all treatment satisfaction questions (range, 1-7) was 5.2±1.2 immediately after the treatments and 5.1±1.3 at follow-up. In total, patients initially dissatisfied with the appearance of their buttocks reported a significant 85% improvement after the fourth treatment. Immediately after the fourth treatment, all the subjects reported that their buttocks felt more lifted and toned. Results were maintained at one-month follow-up. Weight of the patients didn't change significantly. Digital photographs showed aesthetic improvements of the buttocks for most of the patients. No adverse events were reported. Conclusion: The results show that the investigated device safely and effectively improves the aesthetic appearance of buttocks non-invasively. The treatments not only resulted in a significant visual improvement but also increased patient confidence and satisfaction. The procedure is suitable for patients seeking improvement in tone, shape, lift, and tightness of the buttocks. J Drugs Dermatol. 2018;17(11):1229-1232.

Cost and efficacy of intravenous streptokinase plus PTCA for acute myocardial infarction when therapy is initiated in community hospitals.

The costs and clinical results of a thrombolytic therapy protocol using intravenous (IV) streptokinase in small community hospitals prior to emergency transfer for cardiac catheterization for possible percutaneous transluminal coronary angioplasty (PTCA) were prospectively studied in 56 patients with an acute myocardial infarction [Tulsa Heart Center-Myocardial Infarction Study Team (THC-MIST) protocol]. Findings were compared to those for 53 similar patients receiving "conventional therapy" during the same study period. The reperfusion rate for IV streptokinase was 63%. Additional emergency PTCA yielded a total reperfusion rate of 95%. Despite emergency cardiac catheterization for all THC-MIST patients, average hospital charges were not significantly different between the two groups ($20,495 vs. $20,722; THC-MIST vs. conventional therapy, respectively). Total charges (hospital plus physician fees) were also not significantly different ($22,986 vs. $22,400; THC-MIST vs. conventional therapy, respectively). Intensive care unit (ICU) days and total hospital stays were significantly less for THC-MIST patients (3.1 vs. 5.8 ICU days, p less than 0.05 and 8.8 vs. 12.4 hospital days, p less than 0.05; THC-MIST vs. conventional therapy, respectively). Thus initiation of IV streptokinase in community hospitals for acute myocardial infarction with subsequent transfer for possible PTCA can yield high reperfusion rates without significantly increasing health care costs.