Daily Cosmetic Research Analysis

BACKGROUND: Surgical-site antisepsis is used to prevent surgical-site infections (SSIs). Although several guidelines have indicated the efficacy of antiseptics, such as chlorhexidine, povidone-iodine, and olanexidine, in reducing the SSI rate, an optimal recommendation is still not established. The aim of this study was to evaluate the efficacy of aqueous olanexidine compared with chlorhexidine-alcohol as the optimal antiseptic for preventing SSI in clean-contaminated surgery. METHODS: This multicentre randomized trial for surgical skin antisepsis in clean-contaminated gastrointestinal and hepatobiliary-pancreatic surgeries in five hospitals evaluated the efficacy of olanexidine and chlorhexidine-alcohol. The primary endpoint was 30-day SSI. Secondary outcomes included the occurrence of SSI types, intervention-related toxicity, and reoperation caused by SSI. RESULTS: Overall, 700 patients from five institutions underwent randomization; 347 received olanexidine and 345 received chlorhexidine-alcohol in the full analysis set. The 30-day SSI rate was 12.4% (43 of 347) in the olanexidine group and 13.6% (47 of 345) in the chlorhexidine-alcohol group (adjusted risk ratio (aRR) 0.911 (95% c.i. 0.625 to 1.327); P = 0.626). No significant differences were observed between the groups regarding the secondary outcomes, including the occurrence of superficial incisional SSI, deep incisional SSI, organ/space SSI, and reoperation caused by SSI. Overall adverse effects were seen in two patients (0.58%) in the olanexidine group and in three patients (0.87%) in the chlorhexidine-alcohol group (aRR 0.663 (95% c.i. 0.111 to 3.951)). CONCLUSION: Olanexidine did not significantly reduce the occurrence of overall SSI compared with chlorhexidine-alcohol. Nevertheless, these findings provide valuable insights for developing novel surgical SSI management protocols. REGISTRATION NUMBER: UMIN 000049712 (University Hospital Medical Information Network Clinical Trials Registry).

INTRODUCTION: Cosmetic surgery is marketed and widely considered to exert positive psychosocial outcomes, particularly in relation to body image, self-esteem, and mental health. The present systematic review aimed to conduct a timely, up-to-date assessment of the existing academic empirical literature, applying stringent inclusion criteria to summarize only the highest quality of evidence in the field. METHODS: The following databases were systematically searched: EBSCO, Cochrane Library, Scopus, and ProQuest. Screening was completed by two independent reviewers. Prospective studies that utilized a control cohort to examine at least one psychosocial outcome using a validated measure after cosmetic surgery were included. Risk was double assessed using the Effective Public Health Practice Project Quality Assessment Tool. RESULTS: Seventeen studies met the inclusion criteria. There was considerable heterogeneity across research designs, control groups, measures, and statistical analyses. Overall, the quality of studies was poor. Results suggest short-term improvements in some psychosocial outcomes after cosmetic surgery (particularly in relation to body-area-specific satisfaction, self-esteem, sexual well-being and physical well-being), with limited and inconclusive evidence for outcomes such as mental health, holistic body image, quality of life and social functioning. Very few studies have explored psychosocial outcomes beyond 6-months after the surgery. CONCLUSION: Current evidence regarding psychosocial outcomes following cosmetic surgery is weak. There is an urgent need to conduct high-quality research that will require collaboration among surgeons, research psychologists, and methodologists. Recommendations include pre-registration, larger sample sizes, longer follow-up duration, and appropriate control group recruitment. Considering the increasing popularity of cosmetic surgery globally, this field of research should assume priority.

INTRODUCTION: Two phase 3 trials (TRuE-V1 and TRuE-V2) demonstrated that a topical formulation of the Janus kinase (JAK) 1/JAK2 inhibitor ruxolitinib significantly improved repigmentation versus vehicle cream in adolescent and adult patients with vitiligo. This post hoc analysis of pooled TRuE-V1/TRuE-V2 data evaluated efficacy and safety by baseline demographics and clinical characteristics. METHODS: Patients aged ≥ 12 years with nonsegmental vitiligo were randomized to vehicle cream or 1.5% ruxolitinib cream twice daily for 24 weeks, after which all patients could apply ruxolitinib cream through Week 52. Efficacy was evaluated using achievement of ≥ 75% improvement from baseline in facial Vitiligo Area Scoring Index [F-VASI75] at Week 52. Safety assessments included the frequency of treatment-emergent adverse events (AEs) and treatment-related AEs. RESULTS: The TRuE-V studies enrolled 674 patients. Week 52 F-VASI75 was achieved by 50.3% (176/350) of patients who applied ruxolitinib cream throughout and 28.2% (46/163) who crossed over from vehicle to ruxolitinib cream after Week 24. F-VASI75 responses were observed across subgroups regardless of patient age, sex, Fitzpatrick skin type, affected facial body surface area, disease duration, disease stability, and prior treatment status. Treatment-emergent AEs occurred in 52.1% (332/637) of patients, and treatment-related AEs occurred in 13.7% (87/637); rates were generally similar across demographic subgroups. CONCLUSIONS: Adolescent and adult patients with vitiligo who applied ruxolitinib cream could achieve clinically meaningful repigmentation per F-VASI75 response at 1 year, regardless of their baseline demographics or clinical characteristics. Ruxolitinib cream was well tolerated, with a similar incidence of treatment-emergent and treatment-related AEs across subgroups. TRIAL REGISTRATION: NCT04052425/NCT04057573. Vitiligo is a disease that causes white patches on the skin. Two large clinical trials, each 1 year long, showed that applying a topical treatment called ruxolitinib cream resulted in a return of skin color to white patches. The analysis described here used data from these two clinical trials to determine whether ruxolitinib cream is safe and effective for treating vitiligo in different subgroups of people with vitiligo. These subgroups were based on age, sex (men/women), and skin tone, as well as features of their disease, such as how long they had vitiligo. The authors found that ruxolitinib cream recolored white patches on the faces of many people who treated their skin for 1 year. This was true regardless of how old they were, whether they were men or women, and how fair or dark their skin was. This was also true regardless of differences in the disease, including whether they had vitiligo for a short or a long time, how much of their face was originally covered in white patches, if they had white patches that stayed the same or changed a lot before the trial, and whether they tried other treatments before. Ruxolitinib cream was previously shown to have generally mild side effects. Importantly, the authors here found that side effects did not differ between patient subgroups. These results show that ruxolitinib cream is an effective and safe option to treat vitiligo across a diverse population of patients.