Studying the satisfaction of patients on the outcome of an aesthetic dermatological filler treatment

Background: Many factors contribute to extend productive life in the modern world. Competition makes people worry about physical appearance, mosftly in respect to facial and skin aging. This has motivated new developments in cosmetic dermatology and the need of evaluating patient satisfaction with the new proposed treatments. Poll questionnaire has been used for such evaluation, and the analysis of the electroencephalogram (EEG) mapping obtained while the patient answers the satisfaction questionnaire may render the results less subjective. Objectives: The purpose of this paper is to study the satisfaction of a group of 33 women (mean age, 44.years) treated with hyaluronic acid filling of nasolabial folding or lips, combining the EEG brain mapping and questionnaire techniques. Methods: At the third month of evaluation, two networked personal computers were used for the EEG recording and for presenting the patient with a questionnaire about her well-being feeling; self-evaluation of her face; her satisfaction with the results of the aesthetic treatment; how the family, friends, and people at work evaluated the result of the treatment; and her decision to repeat the treatment and to recommend it to friends and family. Results: Poll results showed that patients were feeling well and were satisfied with the results of the aesthetic treatment. Furthermore, the regression EEG mappings showed patients to be satisfied with their appearance and with the treatment involving similar brain areas. Conclusion: Patients decided to undergo the treatment because they were already considering it (54%) or because they were dissatisfied with their lips or nasolabial folding (52%). The fact that the treatment was free of charge solidified the decision. Patients consider themselves as good-looking and they wanted to preserve such a condition. © 2008 Wiley Periodicals, Inc.

Autologous orbicularis muscle for filling facial foldsan experimental and clinical study

Purpose: To present a technique for filling facial folds by using autologous orbicularis oculi muscle, based on an experimental model. Methods: two studies are presented: (1) an experimental study using 15 albino guinea-pigs from which a strip of the sural triceps muscle was removed and implanted in the subcutaneous tissue of the dorsal area. The animals were sacrificed 7, 30 and 60 days after the implantation, and the material was histologically evaluated. And (2%) an interventional prospective clinical trial carried out on 20 patients referred to blepharoplasty surgery. They received autologous preseptal orbicularis muscle for filling facial folds. The results where evaluated by patients satisfaction and clinical exam. Results: the sural tricep muscle, when implanted in the subcutaneous tissue, resulted in fibrosis. The patients whom received autologous orbicularis muscle implanted for filling facial folds showed that the procedure can be successfully carried out. Conclusions: autologous preseptal orbicularis muscle is a good material for filling facial folds. Cicatricial tissue will be formed on its implantation site, filling the tissue gap that forms the folds on the skin.

Tourism life cycle, tourism competitiveness and upgrading strategies in the Caribbean

In the 1980s Butler adapted the life cycle product model to the tourism industry and created the “Tourism Area Life Cycle (TALC) model”. The model recognizes six stages in the tourism product life cycle: exploration, investment, development, consolidation, stagnation and followed, after stagnation, by decline or revitalization of the product. These six stages can in turn be regrouped into four main stages. The Butler model has been applied to more than 30 country cases with a wide degree of success. De Albuquerque and Mc Elroy (1992) applied the TALC model to 23 small Caribbean island States in the 1990s. Following De Albuquerque and Mc Elroy, the TALC is applied to the 32 member countries of the Caribbean Tourism Organization (CTO) (except for Cancun and Cozumel) to locate their positions along their tourism life-cycle in 2007. This is done using the following indicators: the evolution of the level, market share and growth rate of stay-over arrivals; the growth rate and market share of visitor expenditures per arrival and the tourism styles of the destinations, differentiating between ongoing mass tourism and niche marketing strategies and among upscale, mid-scale and low-scale destinations. Countries have pursued three broad classes of strategies over the last 15 years in order to move upward in their tourism life cycle and enhance their tourism competitiveness. There is first a strategy that continues to rely on mass-tourism to build on the comparative advantages of “sun, sand and sea”, scale economies, all-inclusive packages and large amounts of investment to move along in Stage 2 or Stage 3 (Cuba, Dominican Republic, Puerto Rico). There is a second strategy pursued mainly by very small islands that relies on developing specific niche markets to maintain tourism competitiveness through upgrading (Anguilla, Antigua and Barbuda, British Virgin Islands and Turks and Caicos), allowing them to move from Stage 2 to Stage 3 or Stage 3 to a rejuvenation stage. There is a third strategy that uses a mix of mass-tourism, niche marketing and quality upgrading either to emerge onto the intermediate stage (Trinidad and Tobago); avoid decline (Aruba, The Bahamas) or rejuvenate (Barbados, Jamaica and the United States Virgin Islands). There have been many success stories in Caribbean tourism competitiveness and further research should aim at empirically testing the determinants of tourism competitiveness for the region as a whole.

Políticas públicas: a construção de imagens e sentidos para o envelhecimento humano

The present study aims to analyze the Brazilian public policies made for the elderly citizen population and to examine their resonance in the production of senses and images on the process of aging. For this, we draw cartographies that could find producing figures of sense about the aging, passing through some politics formulated for to this age group, since the decade of 1920 until the creation of the “Estatuto do Idoso”, in 2003. We checked that the appearance of public policies for the old age happened as an answer to the challenge of managing and controlling the aging process courses in front of the increase of the elderly citizen population. The “Estatuto do Idoso” is an important landmark of the management advance of the State upon the oldness and of the substitution of an philanthropic-assistance model for a preventive model which is based on the promotion of a healthy and productive longevity. With that, next to the figure of the sick and inactive elderly , it begins to appear figurations of a healthy and powerful aging, crossed by images of vitality and rejuvenation.

Development of an anti aging cream with AHA/BHA and sunscreens

The skin aging is a matter of discomfort verified in the population. Thus, every day, new products are launched on the market to offer different manners to prevent the premature aging of the skin. In this context, active substances, as alpha and beta hidroxyacids (AHA/BHA), beyond the sunscreens, are considered a way of prevention and amelioration of the effects caused in the skin due to the time. The aim of this study was to develop and evaluate a cosmetic cream containing AHA/BHA and sunscreen. It was studied in relation to its physical-chemical and microbiological characteristics. According to the results, the formulation developed present a shelf life of 758 days and the preservative system was effective. Considering the parameters evaluated, the cream probably would be commercially accepted.

Development of an anti-aging cream with AHA/BHA and sunscreens

The skin aging is a matter of discomfort verified in the population. Thus, every day, new products are launched on the market to offer different manners to prevent the premature aging of the skin. In this context, active substances, as alpha and beta hidroxyacids (AHA/BHA), beyond the sunscreens, are considered a way of prevention and amelioration of the effects caused in the skin due to the time. The aim of this study was to develop and evaluate a cosmetic cream containing AHA/BHA and sunscreen. It was studied in relation to its physical-chemical and microbiological characteristics. According to the results, the formulation developed present a shelf life of 758 days and the preservative system was effective. Considering the parameters evaluated, the cream probably would be commercially accepted.

Clonagem do pessegueiro 'Aurora-1' e de portaenxertos de umezeiro

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

The influence of rifting on escarpment migration on high elevation passive continental margins

Using numerical models that couple surface processes, flexural isostasy, faulting and the thermal effects of rifting, we show that fault-bounded escarpments created at rift flanks by mechanical unloading and flexural rebound have little potential to "survive" as retreating escarpments if the lower crust under the rift flank is substantially stretched. In this configuration, a drainage divide that persists through time appears landward of the initial escarpment in a position close to a secondary bulge that is created during the rifting event at a distance that depends on the flexural rigidity of the upper crust. Moreover, the migration of the escarpment to the secondary bulge occurs when the pre-rift topography dips landward, otherwise the evolution of the escarpment is guided by the pre-existing inland drainage divide. To illustrate this new mechanism for the evolution of passive margins, we study the examples of Southeastern Australia and Southeastern Brazil. We propose that a pre-existing inland drainage divide with rift related flank uplift can produce the double drainage divide observed in Southeastern Australia. On the other hand, we conclude that it is possible that the Serra do Mar escarpments on the Southeastern Brazilian margin originated as a secondary flexural bulge during rifting that persisted through time. In both cases, the retreating escarpment scenario is unlikely and the present-day margin morphology can be explained as resulting from rift-related vertical motions alone, without requiring significant post-rift "rejuvenation".

3D Face Reconstruction from 2D Pictures: First Results of a Web-Based Computer Aided System for Aesthetic Procedures

The human face is a vital component of our identity and many people undergo medical aesthetics procedures in order to achieve an ideal or desired look. However, communication between physician and patient is fundamental to understand the patient’s wishes and to achieve the desired results. To date, most plastic surgeons rely on either “free hand” 2D drawings on picture printouts or computerized picture morphing. Alternatively, hardware dependent solutions allow facial shapes to be created and planned in 3D, but they are usually expensive or complex to handle. To offer a simple and hardware independent solution, we propose a web-based application that uses 3 standard 2D pictures to create a 3D representation of the patient’s face on which facial aesthetic procedures such as filling, skin clearing or rejuvenation, and rhinoplasty are planned in 3D. The proposed application couples a set of well-established methods together in a novel manner to optimize 3D reconstructions for clinical use. Face reconstructions performed with the application were evaluated by two plastic surgeons and also compared to ground truth data. Results showed the application can provide accurate 3D face representations to be used in clinics (within an average of 2 mm error) in less than 5 min.

Water versus ice: The competing roles of modern climate and Pleistocene glacial erosion in the Central Alps of Switzerland

Recent studies have identified relationships between landscape form, erosion and climate in regions of landscape rejuvenation, associated with increased denudation. Most of these landscapes are located in non-glaciated mountain ranges and are characterized by transient geomorphic features. The landscapes of the Swiss Alps are likewise in a transient geomorphic state as seen by multiple knickzones. In this mountain belt, the transient state has been related to erosional effects during the Late Glacial Maximum (LGM). Here, we focus on the catchment scale and categorize hillslopes based on erosional mechanisms, landscape form and landcover. We then explore relationships of these variables to precipitation and extent of LGM glaciers to disentangle modern versus palaeo controls on the modern shape of the Alpine landscape. We find that in grasslands, the downslope flux of material mainly involves unconsolidated material through hillslope creep, testifying a transport-limited erosional regime. Alternatively, strength-limited hillslopes, where erosion is driven by bedrock failure, are covered by forests and/or expose bedrock, and they display oversteepened hillslopes and channels. There, hillslope gradients and relief are more closely correlated with LGM ice occurrence than with precipitation or the erodibility of the underlying bedrock. We relate the spatial occurrence of the transport- and strength-limited process domains to the erosive effects of LGM glaciers. In particular, strength-limited, rock dominated basins are situated above the equilibrium line altitude (ELA) of the LGM, reflecting the ability of glaciers to scour the landscape beyond threshold slope conditions. In contrast, transport-limited, soil-mantled landscapes are common below the ELA. Hillslopes covered by forests occupy the elevations around the ELA and are constrained by the tree line. We conclude that the current erosional forces at work in the Central Alps are still responding to LGM glaciation, and that the modern climate has not yet impacted on the modern landscape.

Adverse effects of fillers and their histopathology.

Injectable fillers nowadays represent a pillar in facial rejuvenation and make a significant contribution to the success of the treatment. Despite their obvious benefits, a wide range of possible complications such as immediate, late, delayed, temporary, or irreversible adverse effects have to be respected. Differentiating the various filler materials, these effects are assigned to histopathology findings and currently available treatment options.

European Dermatology Forum Guidelines on topical photodynamic therapy

Topical photodynamic therapy (PDT) is a widely approved therapy for actinic keratoses, squamous cell carcinoma in-situ, superficial and certain thin basal cell carcinomas. Recurrence rates are typically equivalent to existing therapies, although inferior to surgery for nodular basal cell carcinoma. PDT can be used both as a lesional or as a field therapy and has the potential to delay/reduce the development of new lesions. PDT has also been studied for its place in the treatment of, as well as its potential to prevent, superficial skin cancers in immune-suppressed patients, although sustained clearance rates are lower than for immunocompetent individuals. Many additional indications have been evaluated, including photo-rejuvenation and inflammatory and infective dermatoses. This S2 guideline considers all current and emerging indications for the use of topical photodynamic therapy in Dermatology, prepared by the PDT subgroup of the European Dermatology Forum guidelines committee. It presents consensual expert recommendations reflecting current published evidence. An unabridged version of this guideline is available online at: http://www.euroderm.org/edf/index.php/edf-guidelines.