SummarySocio-ecological models suggest that many elements of the social environment act as upstream determinants of obesity. This systematic review examined definitions, measures and strength of associations between the psychosocial environment and adult weight status. Studies were included if they were conducted on adults, the outcome was weight status, carried out in any developed country and investigated at least one psychosocial environmental construct. Six databases for primary studies were searched: EMBASE, MEDLINE, PsycINFO, Scopus, Web of Science and the Cochrane Library. We restricted our search to studies published in English between January 1995 and February 2015. An adapted 'Quality Assessment Tool for Quantitative Studies' was used to evaluate risk of bias of included studies. Out of 14,784 screened records, 42 articles were assessed using full text. A total of 19 studies were included. The strongest associations with weight status were found for social capital and collective efficacy, although few studies found significant associations. There was heterogeneity in the definitions and metrics of psychosocial environmental constructs. There is limited evidence that greater social capital and collective efficacy are associated with healthier weight status. The research conducted to date has not robustly identified relations. We highlight challenges to undertaking research and establishing causality in this field and provide recommendations for further research.
Introduction: Asian patients often seek to address lower facial aging through clinical interventions that increase anterior projection and jawline contouring. The Definisse TM (also known as Happy Lift TM ) thread lift treatment uses barbed absorbable threads to suspend tissues and induce biostimulation. We evaluated the efficacy and safety of absorbable barbed threads for lower facial reshaping in Thai patients. Methods: This prospective, evaluator-blinded study enrolled 27 Thai patients diagnosed with mild to moderate facial laxity. Patients underwent thread implantation along the mandibular angle with one of two double needle thread lengths (12 and 23 cm) to create a ''J stitch''. Primary outcome was the clinical improvement in facial laxity as graded by two blinded dermatologists at baseline, immediately after treatment, and at 1 week and 1, 2, 3, 6, and 12 months follow-up. Objective measurements included volume in the jawline, nasolabial folds, and submental area. Patients' self-assessment scores and adverse reactions were recorded. Results: Of the 27 patients recruited to the study, 25 (92.6%) attended all follow-up visits. Clinical improvement of facial laxity was observed immediately after thread implantation. There was significant volume improvement in the jawline, nasolabial folds and submental area at almost all follow-up visits (p \ 0.007), with most patients (51.9%) reporting excellent lifting effect as early as the 1 week follow-up visit. All adverse reactions were mild and resolved spontaneously without any medical intervention. Conclusion: Implantation of absorbable barbed threads is a safe and effective treatment for facial rejuvenation in Thai patients. Long threads (23 cm) showed a slight superiority to short threads (12 cm) in terms of face-lifting efficacy, which suggests the benefit of additional barbs in tissue suspension and biostimulation. The disadvantage of absorbable threads is that their visible lifting effects are not as longlasting as those of non-absorbable ones, since they are reabsorbed from 6 months onwards. Trial registration: ClinicalTrials.gov identifier: TCTR20210415001. This clinical trial was retrospectively registered 12 April 2021.
Port-wine stain (PWS) is a congenital capillary malformation commonly found in the head and neck. With an incidence of 0.3%-0.9% in the newborns, this pathological condition affects males and females equally. 1,2 PWS lesions first appear as pink or red macules that do not undergo spontaneous involution and may progressively darken to reddish purple. 3 The lesions grow proportionately with age and can lead to the formation of papules and nodules or may develop into hypertrophic PWS. 4 Aside from cosmetic disfigurement, PWS hypertrophy may also impair sight, speech, nasal breathing, and hearing. 5 PWS is also associated with two uncommon syndromes: Sturge-Weber syndrome (SWS) and Klippel-Trenaunay syndrome (KTS). 6 SWS is a neurocutaneous disorder characterized by PWS usually affecting one hemiface along one or more trigeminal
Background Multiple treatment modalities have been developed to treat atrophic acne scars with varying degrees of success. Post‐inflammatory hyperpigmentation (PIH) after acne scar treatments remain a major concern in Asian patients. Fractional radiofrequency (FRF) has been used in many dermatological skin conditions including acne scars. Aims To determine the efficacy and safety of FRF nanoneedle system in the treatment of acne scars in Asians. Methods This is a prospective, evaluator‐blinded study with 25 subjects diagnosed with moderate to severe acne scarring. All subjects received 3 monthly treatments of the FRF nanoneedle system on both cheeks. Primary outcome was the clinical improvement of acne scars graded by 2 blinded dermatologists at baseline, 1‐, 3‐, and 6‐month follow‐ups. Objective scar volume analysis was done using ultraviolet A (UVA) light video camera. Subjects’ self‐assessment, pain score, and adverse events were also recorded. Results Twenty‐three out of 25 subjects completed the study and attended all follow‐up. Clinical improvement of acne scars was observed as early as 1‐month follow‐up. Objective evaluation of acne scar volume decreased significantly on all follow‐up compared to baseline (P < .005). Majority of the subjects (48%) reported marked improvement in their acne scars. Adverse events such as pain, erythema, burning sensation, edema, scab formation, and PIH were mild and temporary. Conclusions FRF nanoneedle system is a safe and effective treatment for acne scars in Asians. However, despite the significant changes in the scar volume, caution should be used to avoid excessive coagulation resulting in PIH.
Introduction Port-wine stain (PWS) is a progressive capillary malformation that does not resolve spontaneously without treatment. Pulsed dye laser (PDL) is currently the gold standard treatment for PWS, although it is difficult to attain complete clearance and recurrences are common. This study determined the cost-effectiveness of PDL treatment among Thai patients with facial PWS. Methods This was a retrospective chart review of 109 Thai patients with facial PWS and treated with PDL at Siriraj Hospital, Thailand from January 2008 to December 2017. The primary outcome of the study was the cost-effectiveness of PDL treatment in the clinical improvement of facial PWS. Results Ten PDL treatment sessions will have an expected clinical improvement of 60%. At the 10th treatment, the marginal incremental improvement with respect to visit is approximately equal to one. The succeeding treatment sessions will only give an additional improvement of 5–10%. Conclusion A total of 10 PDL treatment sessions was considered cost-effective as it can achieve 60% clinical improvement among Thai patients with facial PWS.
The rapidly increasing number of COVID‐19‐infected patients and evidence of human‐to‐human transmission even within the asymptomatic incubation period prompted the attention of the entire world. The field of dermatology and procedural dermatology is not exempt from this global issue. We cannot deny the fact that this situation will have a lasting impact on the health‐seeking behaviors of our patients. It is necessary for dermatologists and dermatologic surgeons to be aware of the potential risks and precautions when re‐emerging their practices after COVID‐19.
Introduction Port-wine stain (PWS) is a congenital malformation that does not resolve spontaneously and can cause a physiological or psychological burden to the patients. At present, most of the studies done on PWS are focused on the treatment rather than the quality of life and psychological effects of the disease. Material and Methods A comprehensive literature search was done in MEDLINE using PubMed database, Embase ® , and Cochrane. All observational studies were included in this review. Results A total of 17 relevant articles with 2,135 PWS patients were included in this review. There were 36 measurement tools used to assess the quality of life and the psychological effects among PWS patients. The results showed that patients with facial PWS had a significant negative effect on their quality of life and had also suffered from psychological disabilities. The PWS lesion tends to worsen with age and may cause further adaptation problems towards the social environment, especially in children. Conclusion Early treatment, psychological assistance, and patient support are the key management in improving the quality of life of patients with PWS. Quality of life must be regularly assessed together with the improvement of treatment.
Topical corticosteroid delivery following fractional laser treatment is an effective means of treating hypertrophic scars. However, the relative efficacy of adjuvant corticosteroid treatment vs fractional laser monotherapy alone is unclear. The aim of this study was to compare the efficacy and safety of fractional laser-assisted topical corticosteroid delivery with fractional laser monotherapy in the treatment of hypertrophic scars. In this randomized, comparative, split-scar trial of 19 subjects, a borderline significant reduction in scar thickness was observed at 3-month follow-up in the laser+steroid group compared with laser+petrolatum (p = 0.049). However, no significant long-term difference in scar flattening was observed between the 2 groups. Patient and Observer Scar Assessment Scale scores showed significant improvement in scar appearance from baseline without significant differences between treatment groups. In conclusion, fractional laser monotherapy is an effective treatment for hypertrophic scars, and the application of topical corticosteroid provides no long-term synergistic effect to fractional laser monotherapy.
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