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Background and ObjectivesMonopolar radiofrequency (RF) treatment is used by physicians to tighten and contour the skin of their patients. In many cases, patients have received prior treatment with other aesthetic modalities such as soft‐tissue augmentation or they may wish to receive these treatment modalities simultaneously. Together, soft‐tissue augmentation and monopolar RF treatment have the potential to restore tissue volume and improve facial laxity. To date, no published studies have documented the effects of RF treatment directly over soft‐tissue fillers.Study Design/Materials and MethodsWe examined the tissue interactions of monopolar RF heating with five commonly injected fillers in a juvenile pig model. This is the first part of a two‐part study. In this study, the interaction of monopolar RF and filler substances was examined over a period of 4 months. The five soft‐tissue fillers examined were cross‐linked human collagen (Cosmoplast™), hyaluronic acid (Restylane®), calcium hydroxylapatite (Radiesse™), polylactic acid (Sculptra™), and liquid injectable silicone (Silikon™ 1000).ResultsThere was no apparent increase in the risk of local burns and no observable effect of RF treatment on filler persistence in the tissue. With monopolar RF treatment, an increase in fibroplasia and collagen deposition surrounding Restylane, Radiesse, and Sculptra was observed. When scored in a blinded fashion, the increase in collagen deposition was statistically significant for Radiesse.ConclusionsIn this animal study, RF treatment had no observed adverse effect on filler collagen responses or persistence. Filler presence did not increase the risk of undesirable thermal effects with monopolar RF treatment. Further clinical studies are required to evaluate the effect of monopolar RF treatment over dermal fillers with respect to aesthetic outcome. Lasers Surg. Med. 00:1–10,2005. © 2005 Wiley‐Liss, Inc.

BACKGROUND: Whether cooking with solid fuels, as occurs widely in developing countries, including Nepal, is a risk factor for pulmonary tuberculosis (PTB) is uncertain. Epidemiologic studies have produced variable results. This case-control study sought to resolve this issue with a large sample size and a population-based control group. METHODS: PTB cases (N = 581), aged 18 to 70 were recruited from diagnostic centers in Kaski and neighboring districts of Nepal. Population-based controls (N = 1,226) were recruited. Persons who had previously been diagnosed with TB were excluded. Questionnaires were administered at participants’ homes. RESULTS: Using liquefied petroleum gas (LPG) as the cookstove reference fuel, for women the odds ratio (OR) for having a primary cookstove that used wood was 0.21 (95% CI: 0.08,0.52); for men the corresponding OR was 0.80 (0.37, 1.74). For biogas, the OR for women was 0.24 (0.06,0.87) and for men, 1.41 (0.61, 3.23). CONCLUSIONS: The unexpected finding of a higher risk for women using LPG cookstoves, relative to wood or biogas-burning cookstoves, may be attributable to excluding persons with prior TB. A possible explanation is that emissions, such as ultrafine particles, formed during LPG combustion promote PTB manifestation in infected people who have not previously had PTB. The damage from the initial PTB leaves them susceptible to the PTB-promoting effects of smoke from wood fires. Further studies, excluding participants who have previously had TB are needed to confirm these findings. Use of exhaust hoods to the outdoors for all stoves, well-ventilated kitchens, and gas stoves raised above ground would reduce exposures.

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Monopolar RF treatment levels that are typically used in the clinical setting were employed in this animal study. RF treatment resulted in measurable and statistically significant histological changes associated with the various filler materials. Additional clinical and histological studies are required to determine the optimal timing of monopolar RF treatment and filler placement for maximal potential aesthetic outcome.