Hand Rejuvenation with Customizable Hybrid Fillers: Premixed Calcium Hydroxyapatite and Hyaluronic Acid.

INTRODUCTION: Hand aging is a prevalent concern characterized by the atrophy of local soft tissues and increased visibility of vessels and tendons. Hyaluronic acid (HA) and calcium hydroxyapatite (CaHA) are well-established treatments for addressing this issue. While hybrid filler containing HA and CaHA has been proposed for facial rejuvenation, studies investigating its efficacy for hand rejuvenation are lacking. OBJECTIVE: This study aims to assess the safety and efficacy of a premixed hybrid filler containing calcium hydroxyapatite (CaHA) and hyaluronic acid (HA) for hand rejuvenation. METHODS: A prospective, double-blind, controlled trial was conducted. The control arm (CA) received conventional subdermal treatment with CaHA at a 1:1 dilution. The intervention arm (IA) underwent hybrid treatment, consisting of CaHA at a 1:1 dilution combined with 1 ml of low-density HA. Evaluation was performed subjectively using the Global Aesthetic Improvement Scale (GAIS) and the Manchester Hand Grading System (MHGS), and objectively using cutometry, corneometry, and ultrasound. RESULTS: Both the CA and the IA exhibited high rates of patient satisfaction and satisfaction as assessed by blinded evaluators. Although numerical superiority was observed in the IA, no statistical difference was found between the two groups. Significant improvements in hydration, elasticity, and skin thickness were observed in both arms, with no discernible difference between them. Greater ultrasound echogenicity was noted in the IA, which, as indicated by existing literature, may suggest enhanced biostimulation. No adverse effects were reported in either arm. CONCLUSION: Premixed filler containing HA and CaHA for hand rejuvenation appears to be a safe and effective approach. LEVEL OF EVIDENCE I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Ultrasound of Benign Cutaneous Tumors and Pseudotumors: The Key Lesions.

Benign cutaneous tumors are commonly seen in daily practice. Most of these lesions are diagnosed based on clinical appearance, but in some cases, clinical findings are nonspecific. A diagnostic imaging exam is indicated to provide additional information, and the first choice for studying dermatologic lesions is a high-frequency color Doppler ultrasound, a noninvasive technique that can play a relevant role in all cases and give important anatomical information for final diagnosis and proper clinical management. This article aims to show the most common benign skin lesions emphasizing clinical-sonographic correlation and familiarizing radiologists with the sonographic appearance of the key benign cutaneous tumors.

Assessment of the Interference of Hyperdiluted Calcium Hydroxyapatite for Neck Rejuvenation in the Ultrasonographic Evaluation of Thyroid.

BACKGROUND: Sagging neck skin is a common complaint, and the use of calcium hydroxyapatite injection is a traditional treatment approach for this region. The published literature is limited concerning the possible interference in imaging exams of hyperdiluted product, which presents radiopaque features, for the assessment of deep structures to the application. OBJECTIVE: To assess possible interferences in the ultrasonographic evaluation of thyroid after application of hyperdiluted CaHA on the neck region. METHODS: This was a prospective, blinded, and controlled study. Patients had their cervical regions treated with diluted CaHA (1:4). Ultrasonographic evaluations of thyroid were conducted on day 0 (pre-procedure), day 15, and day 60 by two radiologists blinded to the application. RESULTS: On day 0 no exclusion criteria were observed. On day 15 technical artifacts that difficulted the evaluation but did not make the complete assessment of the thyroid unable, were seen. On day 60 the artifacts of posterior acoustic shadowing were considerably reduced, not bringing any difficulty whatsoever for evaluation of the gland. CONCLUSION: Treatment of sagging neck skin with diluted CaHA in 1:4 does not negatively impact the ultrasonographic evaluation of the thyroid as early as 15 days, and particularly after 60 days from the procedure.J Drugs Dermatol. 2022;21(11):1243-1248. doi:10.36849/JDD.6877.

Safety of the inferolateral orbital access for filling the temporal region with the fanning technique.

INTRODUCTION: The anatomical complexity of the temporal region makes it so treatments with fill-ins are challenging due to high vascular risk. Techniques which provide safer procedures must be encouraged. GOAL: Suggest access to the temple through the inferolateral orbital region as a means for safer temporal fill-ins. METHODS: The fanning technique was plotted out not only via the conventional access (pretragal) but via the proposed one as well. The superficial temporal artery (STA) was mapped with ultrasound. The angles for each of the five retroinjection vectors were calculated in relation to STA and their mean was extracted. The longitudinality of the vector in regard to the vessel was considered the least safe factor. RESULTS: The mean injection angle towards the artery was a 35-degree angle for the conventional access technique and a 73-degree angle for the inferior-lateral orbital access technique (p < 0.05). The more a degree is tangential to the vessel, the higher the chances for inadvertent puncture due to small technical issues. The safety of the procedure through the inferolateral orbital access is corroborated with blind ultrasound imaging done in real-time by radiologists. CONCLUSION: The suggested access is shown to be comparably safer from a vascular perspective than the conventional pretragal access.

[Prevalence and factors associated with high blood pressure, awareness, and treatment among elderly in Southern Brazil]. / Prevalência e fatores associados à pressão arterial elevada, seu conhecimento e tratamento em idosos no sul do Brasil.

The aim of this study was to describe prevalence, awareness, and treatment of high blood pressure (HBP) and associated factors among the elderly in Florianópolis, Santa Catarina State, Brazil. This cross-sectional population-based study used a complex sampling design. HBP was defined as elevated blood pressure (by direct measurement), use of antihypertensive medication, or prior diagnosis. The association of outcomes with independent variables was assessed by Poisson regression. One-thousand seven hundred and five participants were interviewed. Of these, 84.6% presented HBP, 77.5% were aware of their condition, and 79.1% were on antihypertensive medication. Prevalence of HBP was associated with age, functional capacity, and body mass index (BMI). Awareness of the condition was associated with age, gender, BMI, self-rated health, and recent medical consultation. Treatment was associated with gender, functional capacity, self-rated health, and recent medical consultation. Although public health policies should include everyone, unequal distribution of HBP in the population should be addressed through targeted preventive, diagnostic, and therapeutic measures.

Prevalência e fatores associados à pressão arterial elevada, seu conhecimento e tratamento em idosos no sul do Brasil / Prevalence and factors associated with high blood pressure, awareness, and treatment among elderly in Southern Brazil / Prevalencia y factores asociados a la presión arterial elevada, su conocimiento y tratamiento en ancianos en el sur de Brasil

O objetivo foi estimar a prevalência e investigar os fatores associados à pressão arterial elevada, seu conhecimento e tratamento em idosos de Florianópolis, Santa Catarina, Brasil. Trata-se de estudo transversal de base populacional e amostra complexa. A pressão arterial elevada foi definida pela medida do nível pressórico ou uso de anti-hipertensivo, ou diagnóstico prévio. A associação dos desfechos com as variáveis independentes foi verificada pela regressão de Poisson. Foram entrevistados 1.705 idosos. Desses, 84,6% apresentaram pressão arterial elevada, 77,5% estavam cientes da doença e 79,1% a tratavam. A prevalência associou-se à dependência funcional e idade e índice de massa corporal (IMC) elevados. Idosos do sexo feminino, idade e IMC elevados, pior percepção em saúde e consulta médica recente estavam mais cientes da doença. O tratamento associou-se a sexo masculino, dependência funcional, pior percepção em saúde e consulta médica recente. Ainda que políticas públicas em saúde devam ser universais, é preciso considerar a desigual distribuição da pressão arterial elevada na população, direcionando-se ações de prevenção, diagnóstico e garantia de tratamento.

The aim of this study was to describe prevalence, awareness, and treatment of high blood pressure (HBP) and associated factors among the elderly in Florianópolis, Santa Catarina State, Brazil. This cross-sectional population-based study used a complex sampling design. HBP was defined as elevated blood pressure (by direct measurement), use of antihypertensive medication, or prior diagnosis. The association of outcomes with independent variables was assessed by Poisson regression. One-thousand seven hundred and five participants were interviewed. Of these, 84.6% presented HBP, 77.5% were aware of their condition, and 79.1% were on antihypertensive medication. Prevalence of HBP was associated with age, functional capacity, and body mass index (BMI). Awareness of the condition was associated with age, gender, BMI, self-rated health, and recent medical consultation. Treatment was associated with gender, functional capacity, self-rated health, and recent medical consultation. Although public health policies should include everyone, unequal distribution of HBP in the population should be addressed through targeted preventive, diagnostic, and therapeutic measures.

El objetivo fue estimar la prevalencia e investigar los factores asociados a la presión arterial elevada, su conocimiento y tratamiento en ancianos de Florianópolis, Santa Catarina, Brasil. Se trata de un estudio transversal de base poblacional y muestreo complejo. La presión arterial elevada fue definida por la medida del nivel de presión sanguínea el uso de antihipertensivos, el diagnóstico previo. La asociación de los desenlaces con las variables independientes fue verificada por la regresión de Poisson. Se entrevistaron a 1.705 ancianos. De ellos, un 84,6% presentaron presión arterial elevada, un 77,5% eran conscientes de la enfermedad y un 79,1% la trataban. La prevalencia se asoció a la dependencia funcional y edad e índice de masa corporal (IMC) elevados. Ancianos del sexo femenino, edad e IMC elevados, peor percepción en salud y consulta médica reciente, eran más conscientes de la enfermedad. El tratamiento se asoció al sexo masculino, dependencia funcional, peor percepción en salud y consulta médica reciente. Pese a que políticas públicas en salud deben ser universales, es necesario considerar la desigual distribución de la presión arterial elevada en la población, dirigiéndose acciones de prevención, diagnóstico y garantía de tratamiento.