Wound healing and hyper-hydration - a counter intuitive model

Winters seminal work in the 1960s relating to providing an optimal level of moisture to aid wound healing (granulation and re-epithelialisation) has been the single most effective advance in wound care over many decades. As such the development of advanced wound dressings that manage the fluidic wound environment have provided significant benefits in terms of healing to both patient and clinician. Although moist wound healing provides the guiding management principle confusion may arise between what is deemed to be an adequate level of tissue hydration and the risk of developing maceration. In addition, the counter-intuitive model ‘hyper-hydration’ of tissue appears to frustrate the moist wound healing approach and advocate a course of intervention whereby tissue is hydrated beyond what is a normally acceptable therapeutic level. This paper discusses tissue hydration, the cause and effect of maceration and distinguishes these from hyper-hydration of tissue. The rationale is to provide the clinician with a knowledge base that allows optimisation of treatment and outcomes and explains the reasoning behind wound healing using hyper-hydration

Wound bed preparation: A novel approach using HydroTherapy

Wounds that fail to heal quickly are often encountered by community nursing staff. An important step in assisting these chronic or stalled wounds progress through healing is debridement to remove devitalised tissue, including slough and eschar, that can prevent the wound from healing. A unique wound treatment called HydroTherapy aims to provide an optimal healing environment. The first step of HydroTherapy involves HydroClean plus™, this dressing enables removal of devitalised tissue through autolytic debridement and absorption of wound fluid. Irrigation and cleansing provided by Ringer’s solution from the dressing further removes any necrotic tissue or eschar. Once effective wound bed preparation has been achieved a second dressing, HydroTac™, provides an ongoing hydrated wound environment that enables re-epithelialisation to occur in an unrestricted fashion. This paper presents 3 case studies of slow healing wounds treated with HydroClean plus™ which demonstrates effective wound debridement

Outcome Measurement of Beauty and Attractiveness of Facial Aesthetic Rejuvenation Surgery

Aesthetic plastic surgery is a most unusual and unique subspecialty. Unlike other medical and surgical specialties driven primarily by objective medical diagnosis and outcome, aesthetic surgery is patient driven; it represents a special exercise in professional competence by adapting objective medical standards to a mostly subjective field. Given the subjectivity of facial beauty and of the projected aesthetic intervention outcome, in addition to be able to determine beauty of the final result as precisely and objectively as possible, it is also essential to be able to assess patient's satisfaction. However, lack of standardized facial measurements and clear definition of aesthetic outcome and beauty are still major obstacles preventing real change in the consultation dynamics to help better serve patients' expectations. Because of the tremendous increase in demand for all types of facial aesthetic procedures, an objective understanding of aesthetics and beauty is becoming of utmost importance. Recognition of the importance of science and evidence-based medicine is long overdue in our specialty. This study aims at identifying the most recently available evidence-based measures to quantitatively assess beauty and measure outcome of rhytidoplasty that can be useful in everyday aesthetic practice. © 2021 Lippincott Williams and Wilkins. All rights reserved

Estímulo no crescimento e na hidrólise de atp em raízes de alface tratadas com humatos de vermicomposto: ii - efeito da fonte de vermicomposto.

Um dos fatores mais limitantes para a produção de vermicomposto é a disponibilidade de esterco. Neste trabalho, foi avaliado o efeito da substituição parcial do esterco por bagaço de cana e por resíduos de leguminosa (Gliricidia sepium) na vermicompostagem sobre a qualidade do vermicomposto e sobre a bioatividade dos humatos, avaliadas por meio da análise do crescimento radicular e da atividade das bombas de H+ isoladas de raízes de alface. A substituição do esterco por bagaço de cana e por resíduos de leguminosas não acarretou prejuízo às características químicas dos vermicompostos. No entanto, os humatos isolados dos diferentes vermicompostos apresentaram características químicas distintas,tais como: acidez e propriedades óticas distintas. Os humatos produzidos a partir de esterco de bovino e da mistura esterco bovino + bagaço proporcionaram maiores estímulos no crescimento radicular das plantas de alface, sendo os mais indicados para uso na forma solúvel. A inclusão de resíduos de leguminosas no processo de vermicompostagem produziu humatos sem efeito sobre o desenvolvimento das raízes de alface

Evidence-Based Efficacy of High-Intensity Focused Ultrasound (HIFU) in Aesthetic Body Contouring

Abstract: Being profitable procedures with little disposable costs, a number of noninvasive technologies have gained much popularity in recent years and are permeating the aesthetic marketplace. High-intensity focused ultrasound (HIFU) when focused at a targeted depth of 1.1 to 1.6 cm within subcutaneous tissue raises local tissue temperature at the focal point resulting in almost immediate cell death without damage to the surrounding tissues. Despite having gained popularity, little information is available regarding HIFU use for the treatment of localized fat and aesthetic body sculpturing. The current literature review is intended to investigate evidence-based efficacy of HIFU in aesthetic body contouring. Level of Evidence IV: 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. © 2020, Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery

Targeted next-generation sequencing of Candidate Regions Identified by GWAS Revealed SNPs Associated with IBD in GSDs

Canine Inflammatory bowel disease (IBD) is a chronic multifactorial disease, resulting from complex interactions between the intestinal immune system, microbiota and environmental factors in genetically predisposed dogs. Previously, we identified several single nucleotide polymorphisms (SNP) and regions on chromosomes (Chr) 7, 9, 11 and 13 associated with IBD in German shepherd dogs (GSD) using GWAS and FST association analyses. Here, building on our previous results, we performed a targeted next-generation sequencing (NGS) of a two Mb region on Chr 9 and 11 that included 14 of the newly identified candidate genes, to identify potential functional SNPs that could explain these association signals. Furthermore, correlations between genotype and treatment response were estimated. Results revealed several SNPs in the genes for canine EEF1A1, MDH2, IL3, IL4, IL13 and PDLIM. Based on the known function of their human orthologues, these results further our insight into their potential contribution to the pathogenesis of IBD in dogs. In addition, several pathways involved in innate and adaptive immunity and inflammatory responses (i.e. T helper cell differentiation, Th1 and Th2 activation pathway, communication between innate and adaptive immune cells and differential regulation of cytokine production in intestinal epithelial cells by IL-17A and IL-17F), were constructed involving the gene products in the candidate regions for IBD susceptibility. Interestingly, some of the identified SNPs were present in only one outcome group, suggesting that different genetic factors are involved in the pathogenesis of IBD in different treatment response groups. This also highlights potential genetic markers to predict the response in dogs treated for IBD

Synergizing the Nexus: Leveraging Constructed Wetlands for Integrated Resource Management in South Africa

The interlinked nexus of water, energy, and food is pivotal for sustainable development, especially in South Africa—a region grappling with resource scarcity and socio-economic inequalities. Constructed wetlands, as a nature-based solution, can play a crucial role in advancing this nexus by providing a multifunctional approach to managing water resources, enhancing biodiversity, and supporting agricultural productivity. In South Africa, governance of these sectors is multifaceted, with significant state and private sector involvement. For constructed wetlands to be successful, it is imperative to navigate these governance structures effectively. The project aims to create a unified management framework for South Africa's water, energy, and food sectors by harnessing the multifunctional benefits of constructed wetlands. As wetlands improve water quality, they will simultaneously support agricultural productivity, contributing to food security. A crucial aspect of the project involves comprehensive stakeholder mapping to ensure inclusive engagement across all sectors, paving the way for collaborative governance. Subsequently, the project will leverage digital twins to create virtual models of these wetlands, offering a real-time, interactive visualization of the nexus, allowing for the precise assessment of interventions and facilitating informed decision-making. By integrating nature-based solutions with cutting-edge technology, the project aspires to establish a blueprint for resource management that can respond dynamically to South Africa's environmental and socio-economic challenge

Percutaneous Thread Lift Facial Rejuvenation: Literature Review and Evidence-Based Analysis

Purpose: Interest in noninvasive facial rejuvenation procedures continues to grow. With the advent of the so-called lunch-time face-lift, suture suspension facial rejuvenation has gained prominence and much popularity largely patient driven rather than data driven. We have published a decade ago a review about this rejuvenation technique. Despite its popularity at that time, serious long-term studies and peer-reviewed data about longevity and patient satisfaction were lacking to our surprise. As 10 years have passed, we have conducted a new systematic PubMed database search limited to the last 10 years interval. Methods: The search identified 192 publications. After screening the titles and abstracts, 20 clinical and 2 experimental studies met the inclusion criteria and were selected for this review. Results: Though thread lift facial rejuvenation is considered to be a promising modality, no new evidence has been added to the literature to support its use. Conclusion: Until evidence-based efficacy and robust data are objectively documented, patients requesting percutaneous facial rejuvenation must be well informed about adverse events, longevity of effect, and limited available data on efficacy. Level of Evidence III: 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. © 2021, Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery

Cryolipolysis (CLL) for Reduction of Localized Subcutaneous Fat: Review of the Literature and an Evidence-Based Analysis

Introduction: In recent years, cryolipolysis (CLL), a noninvasive approach based upon the inherent sensitivity of adipocytes to cold injury, has emerged. However, it is not clear whether available evidence to date about its efficacy justifies aggressive marketing and extensive widespread application by many practitioners without well-defined indications or objectives of treatment. The current review is intended to evaluate available evidence regarding CLL mechanisms of action and its efficacy not only in fat reducing but also in its ability to result in an aesthetically optimal outcome. Materials and Methods: A systematic search of PubMed and Scopus computerized medical bibliographic database was conducted with the search terms “cryolipolysis,” “lipocryolysis,” and “cool sculpting.” Selection criteria included all matched reports with the search terms in their titles. Results: Thirty-two reports matched the inclusion criteria of this review. Five experimental studies were identified and included to further supplement the discussion. Conclusion: Most reports about CLL included in this review lacked rigorous scientific methodology in study design or in outcome measurement. Serious concerns about integrity of many of these reports, particularly with respect to validity of photographic outcome documentation in addition to objectivity, conflict of interest issues, and commercial bias, have been expressed. Further research should be encouraged to prove with methodological rigor positive effects of this treatment modality and to determine categories of patients in whom most favorable outcomes might be expected. Level of Evidence III: 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. © 2020, Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery