伤口世界

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星期四, 17 10月 2019

近100年乳腺癌的外科治疗演变，是医生不懈的努力！

负压引流与创面修复以下文章来源于普外时间，作者萤火虫医生

79 岁的琼瑶于 3 月 12 日在 Facebook 上发的一篇文章（写给儿子和儿媳的一封公开信）引起了热议，大致意思是嘱咐亲人一旦自己患救治希望渺茫的重病，一定不要再全力抢救。

这种观念至今对于很多人来讲仍难以接受。「不能眼睁睁看着他死」、「哪怕有一丝希望，哪怕砸锅卖铁也要去救」「只要还有一口气在，我们就不会放弃治疗」，这些言语医生每天都能听得到。

星期四, 17 10月 2019

安全过年 ll 年关了，价值过万的鱼刺，长啥样？

原创：胡海涛负压引流与创面修复

2018-2-13 20:00 年二十八

医护人员加班，为了一根‘鱼刺’

星期四, 17 10月 2019

从医多年，很多时间在诊治‘腹痛’患者，有一部分患者因为诊治不及时，导致严重并发症，影响一辈子，甚至死亡。我们医生花费了大量的精力和时间，患者花费了大量的费用和承受了巨大的痛苦，结果是医患双方都痛苦，医生和家属的努力都没换到理想的结果！如果早给我们机会，结果可能就不一样了，这是我们医生经常惋惜的感叹。急腹症的处理，时间就是生命！一台手术，一次在有限范围内救治一个患者，一篇科普文章，希望可以帮助更多的朋友！

星期四, 17 10月 2019

患胆结石的母子二人，胆囊切除后的生活质量变化竟然是？

胡海涛负压引流与创面修复

母，54岁，反复右上腹疼痛10年，再发2周，当地医院诊断1.胆囊结石慢性胆囊炎 2.胆总管结石 3.急性胰腺炎，建议开刀手术：胆囊切除+胆总管切开取石，为微创手术就诊我院，先ERCP取胆总管结石时发现胃潴留、十二指肠狭窄，于2016年6月24日行腹腔镜下胆囊切除+胆总管切开取石+一期胆总管缝合+胃大部切除+毕二胃空肠吻合术，术后第9天痊愈出院。

星期四, 17 10月 2019

我们从洗脚开始，1月治愈94岁婆婆两年的烂脚！

胡海涛负压引流与创面修复

简介：霍婆婆，94岁，右足背溃烂2年，曾在多家医院诊治，未愈，2018-3-9就诊我院：

星期四, 17 10月 2019

急诊外科轮转那年的儿童节，用完备用的小手术包！

原创：胡海涛负压引流与创面修复

几年前，急诊科值夜班，17：00接班，刚坐下不久，小儿外伤接踵而至，一直忙到23：00，用完所有小手术包后，才吃晚饭！

K2 Content

An Innovative Treatment Using Calcium Hydroxyapatite for Non-Surgical Facial Rejuvenation: The Vectorial-Lift Technique 2024-11-06 00:00

Virginia Marcia Amaral1 iD• Helena Hotz Arroyo Ramos2 • Fernanda Aquino Cavallieri3 • Mariana Muniz4 • Guilherme Muzy5 • Ada Trindade de Almeida6

1 IVA Medical Institute, Av. dos Bandeirantes 1518, Belo Horizonte CEP: 30.315-032, Brazil

2 Vito´ria, Brazil

3 Rio de Janeiro, Brazil

4 Sa˜o Paulo, Brazil

5 Sa˜o Paulo, Brazil

6 Hospital do Servidor Pu´blico Municipal de Sa˜o Paulo, Sa˜o Paulo, Brazil

Received: 13 January 2024 / Accepted: 9 April 2024 / Published online: 7 May 2024

Virginia Marcia Amaral 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

© The Authors 2024, corrected publication 2024

Abstract Background The facial aging process entails alterations in the volume, shape, and texture of all skin layers over time. Calcium hydroxyapatite (CaHA) is a well-established safe skin filler with unique properties to resolve some skin alterations by stimulating neocollagenesis. The vectoral-lift (V-lift) technique targets the global repositioning of facial structures by addressing distinct anatomical injection planes. It includes deep facial augmentation with Radiesse PlusTM to retain ligament restructuring and superficial subcutaneous enhancement with diluted Radiesse DuoTM. Herein, we present cases that illustrate the use of this approach.

Methods This pilot study enrolled 36 participants (33 women and three men; ages 37–68 years) in a Brazilian clinical setting, and all patients underwent a single treatment. Photographs were taken at rest, in frontal and oblique views, before injection, and 90 days after treatment.

Results Treatment resulted in elevation of the upper and middle face, notable improvements in the infraorbital hollow, and adjustment of the mean facial volume.

Conclusions The V-lift technique is a three-dimensional pan-facial treatment that relies on ligament support and face vectoring to obtain a lifting effect and facial contour restoration. It encompasses deep facial augmentation involving the use of Radiesse PlusTM for restructuring and retaining ligaments and Radiesse DuoTM for superficial subcutaneous enhancement. This approach targets a global repositioning of the facial structures by addressing distinct anatomical injection planes. It achieves a repositioning of the overall facial anatomy without requiring a substantial volumetric expansion.

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.

Keywords Skin aging Collagen Plastic surgery Dermatology Aesthetics Calcium hydroxyapatite Biostimulation
The efcacy of hyaluronic acid fragments with amino acid in combating facial skin aging: an ultrasound and histological study 2024-11-05 00:00

Antonio Scarano1 · E. Qorri2 · A. Sbarbati3 · S. A. Gehrke4 · Alessio Frisone1 · D. Amuso3 · Sergio Rexhep Tari1

Received: 30 March 2024 / Accepted: 17 May 2024 / Published online: 24 June 2024

© The Author(s) 2024

Antonio Scarano

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E. Qorri

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A. Sbarbati

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S. A. Gehrke

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D. Amuso

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Sergio Rexhep Tari

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1 Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Strada Marcello Mucci 38/B, 66100 Chieti, Italy

2 Department of Dentistry, Faculty of Medical Sciences, Albanian University, 1001 Tirana, Albania

3 Department of Neurosciences, Biomedicine and Movement Sciences, Anatomy and Histology Section, School of Medicine, University of Verona, Verona, Italy

4 Department of Research, Bioface/PgO/UCAM, Montevideo, Uruguay

Abstract

Background Various techniques have been employed in aesthetic medicine to combat skin aging, in particular that of the facial region. Hyaluronic acid is utilized to enhance moisture levels and extracellular matrix molecules. This study aims to histologically assess the efects of low molecular weight hyaluronic acid fragments combined with amino acids (HAAM) on facial skin rejuvenation through intradermal microinjections.

Methods A total of twenty women, with an average age of 45 and ranging from 35 to 64 years old, participated in the study, including 8 in menopause and 12 in the childbearing age group. Mesotherapy was used to administer HAAM to the patients. Prior to and three months after the treatment, each patient underwent small circular punch biopsies. Ultrasound examinations were conducted using B-mode, capturing 2D images in longitudinal or transverse orientations with frequencies ranging from 5 to 13 Mega-hertz (MY LAB X8, ESAOTE, Genova, Italy). A total of 60 ultrasound examinations were taken, with 30 collected before treatment and 30 after treatment.

Results The histological analysis demonstrates an increase in fbroblast activity resulting in the production of Type III reticular collagen, as well as an increased number of blood vessels and epidermal thickness. However, the analysis of ultrasound data before and after treatment showed no statistical diference in skin thickness in malar area, chin and mandibular angle.

Conclusions Histological assessments indicate that subcutaneous infltration of HAAM has a substantial impact on the dermis of facial skin.

Keywords Hyaluronic acid · Hyaluronic acid fragments · Amino acid · Fibroblast · Skin aging · Ultrasound
GLP1R Gene Expression and Kidney Disease Progression 2024-11-04 00:00

Jefferson L. Triozzi, MD, MSCI; Zhihong Yu, MS, PhD; Ayush Giri, MS, PhD; Hua-Chang Chen, PhD; Otis D. Wilson, BBA; Brian Ferolito, MS; T. Alp Ikizler, MD; Elvis A. Akwo, MD, MS; Cassianne Robinson-Cohen, PhD; John Michael Gaziano, MD, MPH; Kelly Cho, PhD, MPH; Lawrence S. Phillips, MD; Ran Tao, PhD; Alexandre C. Pereira, MD, PhD; Adriana M. Hung, MD, MPH; for the VA Million Veteran Program

Key Points

Question Are glucagon-like peptide 1 receptor agonists (GLP-1RAs) associated with kidney disease progression?

Findings In this genetic association study of 353 153 adults, higher genetic GLP1R gene expression as a proxy for GLP-1RAs was associated with a small reduction in the risk of kidney disease progression, even after adjusting for obesity and diabetes.

Meaning These findings support a nephroprotective role of GLP-1RAs.

Abstract

IMPORTANCE Glucagon-like peptide 1 receptor agonists (GLP-1RAs) may have nephroprotective properties beyond those related to weight loss and glycemic control.

OBJECTIVE To investigate the association of genetically proxied GLP-1RAs with kidney disease

DESIGN, SETTING, AND PARTICIPANTS This genetic association study assembled a national retrospective cohort of veterans aged 18 years or older from the US Department of Veterans Affairs Million Veteran Program between January 10, 2011, and December 31, 2021. Data were analyzed from November 2023 to February 2024.

EXPOSURES Genetic risk score for systemic GLP1R gene expression that was calculated for each study participant based on genetic variants associated with GLP1R mRNA levels across all tissue samples within the Genotype-Tissue Expression project.

MAIN OUTCOMES AND MEASURES The primary composite outcome was incident end-stage kidney disease or a 40% decline in estimated glomerular filtration rate. Cox proportional hazards regression survival analysis assessed the association between genetically proxied GLP-1RAs and kidney disease progression.

RESULTS Among 353 153 individuals (92.5% men), median age was 66 years (IQR, 58.0-72.0 years) and median follow-up was 5.1 years (IQR, 3.1-7.2 years). Overall, 25.7% had diabetes, and 45.0% had obesity. A total of 4.6% experienced kidney disease progression. Overall, higher genetic GLP1R gene expression was associated with a lower risk of kidney disease progression in the unadjusted model (hazard ratio [HR], 0.96; 95% CI, 0.92-0.99; P = .02) and in the fully adjusted model accounting for baseline patient characteristics, body mass index, and the presence or absence of diabetes (HR, 0.96; 95% CI, 0.92-1.00; P = .04). The results were similar in sensitivity analyses stratified by diabetes or obesity status.

CONCLUSIONS AND RELEVANCE In this genetic association study, higher GLP1R gene expression was associated with a small reduction in risk of kidney disease progression. These findings support pleiotropic nephroprotective mechanisms of GLP-1RAs independent of their effects on body weight and glycemic control.

Custom Mod Mega1

主任医师、教授、博导，南方医科大学第三附属医院（广东省骨科医院）院长

伤口世界

近100年乳腺癌的外科治疗演变，是医生不懈的努力！

安全过年 ll 年关了，价值过万的鱼刺，长啥样？

面对急性腹痛，患者、家属、医生均需重视的问题！

患胆结石的母子二人，胆囊切除后的生活质量变化竟然是？

我们从洗脚开始，1月治愈94岁婆婆两年的烂脚！

急诊外科轮转那年的儿童节，用完备用的小手术包！

学术会议

伤口世界提示

Custom Mod Mega1

主任医师、教授、博导，南方医科大学第三附属医院（广东省骨科医院）院长

伤口世界

近100年乳腺癌的外科治疗演变，是医生不懈的努力！

安全过年 ll 年关了，价值过万的鱼刺，长啥样？

面对急性腹痛，患者、家属、医生均需重视的问题！

患胆结石的母子二人，胆囊切除后的生活质量变化竟然是？

我们从洗脚开始，1月治愈94岁婆婆两年的烂脚！

急诊外科轮转那年的儿童节，用完备用的小手术包！

消息订阅

学术会议

伤口世界提示