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Background With the aging population, the demand for skin anti‐aging treatments has been steadily rising, prompting the development of advanced non‐invasive therapies. Aims To evaluate the efficacy and safety of microfocused ultrasound (MFU) combined with microneedle fractional radiofrequency (MFR) for facial rejuvenation. Methods This study involved 26 patients experiencing facial laxity. Each patient received one full‐face MFU treatment and one MFR treatment on one side of the face, which was randomly assigned. All treatments were performed on the same day. Facial photoaging parameters were assessed using VISIA, skin fat thickness changes were measured via ultrasound, and subjective evaluations were recorded at Months 0, 1, and 3. Side effects were recorded during treatments and each follow‐up visit. Results The VISIA analysis demonstrated notable enhancements in skin texture, wrinkles, pores, spots, and red areas on the combined treatment side. Ultrasound examinations revealed a significant reduction in subcutaneous fat thickness, particularly at the masseter and the middle of the cheek on the combined side. The study showed improvements in the Global Aesthetic Improvement Scale (GAIS) and Wrinkle Severity Rating Scale (WSRS) scores, with the combined treatment side outperforming the control side at the 3 month mark. Over 90% of participants expressed satisfaction with the treatment outcomes. Mild side effects, such as erythema, purpura, and edema, were observed but resolved without special interventions. Conclusions The combination of MFU and MFR for facial rejuvenation is both safe and effective. The combined treatment demonstrates superior enhancement in skin tightening, depigmentation, and pore refinement within a single therapeutic session.

Background Facial inflammation is a highly prevalent condition mediated by diverse etiologies, primarily manifested as facial redness, swelling, itching, pain, maculopapular rash, or even pustules. Conventional treatments such as topical or oral medications for anti‐inflammatory, antibacterial, and immunomodulatory purposes have shown limitations, particularly in the slow resolution of symptoms. While standalone laser therapy or hydrolifting may provide relatively faster symptom relief, their efficacy remains insufficiently stable or durable. Objective This prospective, comparative, and randomized clinical study aims to investigate the therapeutic effects of combining facial microneedling with intense pulse laser (IPL) and hydrolifting for facial inflammation. Methods From January 2022 to January 2024, 114 patients with facial inflammation were enrolled and randomly allocated into one experimental group and two control groups. The experimental group received triple therapy, while the control groups received either hydrolifting alone or IPL monotherapy. Therapeutic outcomes were evaluated by comparing improvements in inflammatory area reduction, aesthetic indicators, Global Aesthetic Improvement Scale (GAIS) scores, and incidence of adverse events post‐treatment. Results Baseline characteristics showed no significant differences among the three groups before treatment. At 2 weeks, 3 months, and 6 months post‐treatment, the experimental group demonstrated significantly better outcomes in inflammatory area reduction and GAIS scores compared to the control groups. Although aesthetic indicators improved in all groups, intergroup differences were not statistically significant. No significant differences in adverse event rates were observed among the groups. Conclusion This prospective, controlled, and randomized clinical study demonstrates that microneedling‐assisted IPL combined with hydrolifting yields superior and more sustained therapeutic efficacy in facial anti‐inflammatory treatment.

Introduction Topical insulin (TI) has been shown to enhance wound healing by promoting re‐epithelialization and collagen synthesis. However, there have been limited studies addressing its potential use in treating acne scars. Objectives To assess the efficacy of combining TI with microneedle fractional radiofrequency (MFR) in the treatment of atrophic acne scars. Materials and Method A split‐face, double‐blinded, placebo‐controlled trial involved 30 participants with atrophic acne scars. Each side of the participants' face was randomly treated with a combination of MFR and TI or a placebo every 4 weeks for four consecutive sessions. Results Significant improvements in scar volume were observed, with statistical significance at week 12 for MFR combined with TI sides (baseline 18.22 ± 9.86 vs. 16.20 ± 8.58 mm3, p = 0.017) and at week 16 for MFR combined with placebo sides (baseline 18.02 ± 9.24 vs. 15.28 ± 8.21 mm3, p = 0.001). The TI sides exhibited a reduction of 46.77% ± 21.33% in Echelle d’ évaluation clinique des cicatrices d’ acne (ECCA) (p ≤ 0.001), while the placebo sides showed a reduction of 46.39% ± 20.14% in ECCA (p ≤ 0.001). There were no significant differences in melanin, and hemoglobin index between the two groups. No hypoglycemic symptoms were reported. Conclusion Combining topical insulin with MFR is safe and could accelerate the early acne scar improvement.

Domiciliary High-flow, humidified, nasal cannula (HFNC) is a possible add-on in patients with chronic respiratory diseases. This post-hoc study investigates benefit of HFNC in subgroups of advanced COPD patients with chronic hypoxic failure on reduction of exacerbations and hospitalizations. One hundred patients were randomized to HFNC in a previous trial. Subgroups with 0-1 (N = 32) respectively two or more (2+) (N = 68) exacerbations 12 months pre-study were investigated. Changes in number of exacerbations and hospitalizations pre- and in study were analyzed, corrected for HFNC days with HFNC. Patients were comparable at baseline. Exacerbations increased in subgroup 0-1 (p = 0.01) and decreased in subgroup 2+ (p = 0.03). Correcting for HFNC days no correlation was seen in subgroup 0-1 (p = 0.08), but in subgroup 2+ (p<0.001). Number of hospitalizations increased in subgroup 0-1 (p = 0.01) with no change in days of hospitalization (p = 0.08). Number and days of hospitalization decreased in subgroup 2+ (p = 0.002 resp. 0.025). Correcting for HFNC days no correlation was found in number or days of hospitalization in subgroup 0-1 (p = 0.48 and p = 0.65). Positive correlation was found in subgroup 2+ (both p<0.001). In patients with advanced COPD, chronic hypoxic failure and two or more exacerbations per year, HFNC significantly reduced exacerbations and hospitalizations.

This study aimed to evaluate the effectiveness of isolated treatment with retinoic acid and its combination with the microneedling technique in facial melasma, seeking to associate these results with possible oxidative damage. This is a blinded randomized clinical trial with 42 women with facial melasma (skin phototype I–IV), randomized into Group A (microneedling and 5% retinoic acid) or Group B (5% retinoic acid alone). Four procedures were applied with 15 days intervals (4 blood collections). Clinical improvement was assessed using the Melasma Area Severity Index (MASI). Serum oxidative stress levels were evaluated by protein oxidation (carbonyl), lipid peroxidation (TBARS) and sulfhydryl groups, as well as enzyme activities of superoxide dismutase (SOD) and catalase (CAT). The statistical analyzes were performed by generalized estimation equation (GEE). There was a reduction in MASI scale and TBARS levels in both groups over time ( p  < 0.05), with no difference between groups ( p  = 0.416). There was also a substantial increase in the carbonyl levels at 30 days ( p  = 0.002). The SOD activity decreased after 30 days, regardless of group ( p  < 0.001), which was maintained after 60 days. In Group A, there was a reduction in sulfhydryl levels at 60 days ( p  < 0.001). It is important to highlight that both groups demonstrated efficacy in the clinical improvement of melasma within at least 60 days, reducing the MASI score by almost 50%. However, microneedling with retinoic acid seems to be the worst treatment because there is a reduction in the non-enzymatic antioxidant defense, which is important to protect against oxidative stress.

Protontherapy is hadrontherapy’s fastest-growing modality and a pillar in the battle against cancer. Hadrontherapy’s superiority lies in its inverted depth-dose profile, hence tumour-confined irradiation. Protons, however, lack distinct radiobiological advantages over photons or electrons. Higher LET (Linear Energy Transfer) 12 C-ions can overcome cancer radioresistance: DNA lesion complexity increases with LET, resulting in efficient cell killing, i.e. higher Relative Biological Effectiveness (RBE). However, economic and radiobiological issues hamper 12 C-ion clinical amenability. Thus, enhancing proton RBE is desirable. To this end, we exploited the p +  11 B → 3α reaction to generate high-LET alpha particles with a clinical proton beam. To maximize the reaction rate, we used sodium borocaptate (BSH) with natural boron content. Boron-Neutron Capture Therapy (BNCT) uses 10 B-enriched BSH for neutron irradiation-triggered alpha particles. We recorded significantly increased cellular lethality and chromosome aberration complexity. A strategy combining protontherapy’s ballistic precision with the higher RBE promised by BNCT and 12 C-ion therapy is thus demonstrated.

ObjectiveEndoscopic balloon dilation (EBD) is a standard treatment for anastomotic strictures after esophagectomy, and requires multiple dilations. We conducted a randomized controlled trial to assess the efficacy of adding a steroid injection to EBD to reduce restricture.MethodsPatients were randomized to receive EBD combined with either triamcinolone or placebo injection. The primary endpoint was the number of dilations required to resolve the stricture. The secondary endpoints were restricture-free survival and adverse events. Patients with a dysphagia symptom score of ≥2 after esophagectomy with an endoscopy-confirmed anastomotic stricture were included. A total of 50 mg of triamcinolone acetonide (50 mg/5 mL) or an identical volume of normal saline solution as a placebo was injected per site using a 25-gauge needle immediately after EBD. Both the patient and treating physician were blinded to the treatment given.ResultsDuring the 4-year study period, 65 patients were randomized to either the steroid group (n = 33) or placebo group (n = 32). The median number of EBDs required to resolve strictures was 2.0 (interquartile range, 1.0–2.5) in the steroid group and 4.0 (interquartile range, 2.0–6.8) in the placebo group (p < 0.001). After 6 months of follow-up, 39% of patients who had received steroid injections remained recurrence free compared with 16% of those who had received saline injections (p = 0.002). No adverse events occurred during follow-up.ConclusionsSteroid injection shows promising results for the prevention of stricture recurrence in patients who underwent EBD for anastomotic strictures.

Ischaemic stroke is one of the leading causes of death and disability worldwide, and intravenous alteplase is the only proven effective treatment in the acute setting. Hypothermia has been shown to improve neurological outcomes after global ischaemia–hypoxia in comatose patients who have had cardiac arrest, and is one of the most extensively studied and powerful therapeutic strategies in acute ischaemic stroke. The protective mechanisms of therapeutic hypothermia affect the ischaemic cascade across several parallel pathways and, when coupled with reperfusion strategies, might yield synergistic benefits for patients who have had a stroke. Technological advances have allowed hypothermia to be induced rapidly, and the treatment has been used safely in acute stroke patients. Conclusive efficacy trials assessing therapeutic hypothermia combined with reperfusion therapies in acute ischaemic stroke are ongoing.

We report on in vitro wound-healing and cell-growth studies under the influence of radio-frequency (rf) cell stimuli. These stimuli are supplied either by piezoactive surface acoustic waves (SAWs) or by microelectrode-generated electric fields, both at frequencies around 100 MHz. Employing live-cell imaging, we studied the time- and power-dependent healing of artificial wounds on a piezoelectric chip for different cell lines. If the cell stimulation is mediated by piezomechanical SAWs, we observe a pronounced, significant maximum of the cell-growth rate at a specific SAW amplitude, resulting in an increase of the wound-healing speed of up to 135 ± 85% as compared to an internal reference. In contrast, cells being stimulated only by electrical fields of the same magnitude as the ones exposed to SAWs exhibit no significant effect. In this study, we investigate this effect for different wavelengths, amplitude modulation of the applied electrical rf signal, and different wave modes. Furthermore, to obtain insight into the biological response to the stimulus, we also determined both the cell-proliferation rate and the cellular stress levels. While the proliferation rate is significantly increased for a wide power range, cell stress remains low and within the normal range. Our findings demonstrate that SAW-based vibrational cell stimulation bears the potential for an alternative method to conventional ultrasound treatment, overcoming some of its limitations.

Objective This study evaluated the efficacy and safety of a sequential protocol for treating solitary, superficial infantile hemangioma (IH). The protocol combined an Advanced Optimal Pulse Technology (AOPT) intense pulsed light system, which was equipped with a novel dual‐band vascular filter, with a subsequent long‐pulsed 1064 nm Nd:YAG laser. We compared this sequential approach to treatment with a long‐pulsed Nd:YAG laser alone. Methods In this retrospective cohort study, 257 treatment‐naïve children with solitary, superficial IH were included. Patients were divided into two groups based on a chronological cutoff following the introduction of a new AOPT intense pulsed light device in March 2024. The combination therapy group (n = 113) received treatment with the AOPT intense pulsed light system immediately followed by the Nd:YAG laser. The monotherapy group (n = 144) was treated with the Nd:YAG laser alone. The primary efficacy endpoint was the overall improvement rate. Time to improvement was analyzed using Cox proportional hazards regression, and safety was assessed by the incidence of adverse events. Results The combination therapy group achieved a significantly higher overall response rate (92.9% vs. 82.6%, p = 0.014). Cox regression analysis confirmed that combination therapy significantly accelerated the time to improvement (hazard ratio = 1.43, 95% CI: 1.08–1.88, p = 0.011). The final complete cure rate and the overall incidence of adverse events were comparable between the two groups. Conclusion For solitary, superficial IH, the sequential treatment protocol using an AOPT intense pulsed light system with an integrated dual‐band vascular filter, followed by long‐pulsed Nd:YAG laser, is a safe and effective local strategy. It significantly accelerates lesion regression and improves the treatment response rate compared to Nd:YAG laser monotherapy.