Daily Cosmetic Research Analysis

The large production volume of volatile methylsiloxanes (VMSs) and their high mobility and persistence present significant environmental-pollution concerns. Although the temporal trends of the persistent-compound concentrations of the environment have been considerably explored, those of surface water, namely surface water VMSs, have been barely investigated. Thus, we investigated the 2013-2021 spatiotemporal trends of the VMS (cyclic VMSs (cVMSs; D3-D6) and linear VMSs (L3-L6)) concentrations of river water and sewage treatment plant (STP) samples from the Tokyo Bay catchment basin, Japan. Our findings indicated the widespread concentrations of VMSs in the river water (2.3-1190 ng/L); the highest VMS levels were detected downstream of the STP discharges. However, no elevated VMS concentrations were detected downstream of silicone-manufacturing facilities, except for D3. The temporal trend analysis revealed statistically significant decreases in the D4, D5, and D6 concentrations within the monitoring period, with annual changes ranging from -7.7 % to -6.4 %, probably reflecting the impact of regulatory actions to address cVMSs. Our risk assessment of the adverse effects of surface water D4, D5, and D6 on aquatic organisms revealed that their distributions did not overlap between the 95th percentile field-water concentration and 5th percentile chronic no-observed-effect water concentration, whereas their cVMS levels were close to their predicted no-observed-effect concentrations. Furthermore, their risks of the aquatic environment to cVMS exposure displayed decreasing temporal trends during the study period. Overall, understanding temporal trends of surface water VMS is key to implementing necessary emission regulations and evaluating the effectiveness of future restrictions on these silicone materials.

BACKGROUND: Cutibacterium acnes (C acnes) is commonly responsible for periprosthetic joint infections after total shoulder arthroplasty (TSA). Chlorhexidine gluconate (CHG) has been shown to decrease the prevalence of C acnes when used in preoperative skin preparations. However, the bacterium is found within the dermal layer of the skin and unable to be completely eradicated with preoperative skin preparations. This study aims to determine if the use of 0.05% CHG lavage of the subcutaneous tissues decreases the incidence of positive superficial and deep C acnes cultures in primary TSA. METHODS: This was a prospective, 2-arm, single-surgeon, single-blinded, randomized controlled trial. All patients scheduled for a primary anatomic or reverse TSA were screened for enrollment at a single institution. Patients were randomized to a saline irrigation or a 0.05% CHG irrigation of the exposed dermal and subcutaneous layer after incision. Five culture samples were taken during surgery. The first was taken from the skin prior to incision and followed by a baseline superficial subcutaneous culture before lavage. Following lavage, 1 additional superficial culture and 2 deep cultures were taken prior to bony preparation. All cultures were incubated and examined for C acnes growth for 21 days. The study was adequately powered at 85% with a type I error rate of 0.05. An ordinal regression analysis for each culture swab site was performed to determine odds ratios (ORs), with the irrigation group (saline/CHG) serving as the independent variable. RESULTS: One hundred twenty six patients were enrolled into 2 groups: normal saline (n = 63) and CHG (n = 63). The 2 groups did not have any significant differences in baseline demographic characteristics. The study group that underwent normal saline irrigation had more than double the risk of C acnes contamination at the deep surgical level compared with the group that had 0.05% CHG as the surgical irrigation solution (OR = 2.21, 95% confidence interval: 1.12-4.37). Furthermore, when male patients were isolated, the risk of C acnes contamination at the deep surgical level was even more pronounced (OR = 2.84, 95% confidence interval: 1.25-6.48). CONCLUSIONS: The use of a 0.05% CHG irrigation solution in the subcutaneous layer leads to a significantly decreased rate of positive deep cultures of C acnes in TSA. Furthermore, in male patients, the decrease in rate of positive deep cultures is even more substantial. We recommend its use in the subcutaneous layer during primary TSA to limit the risk of deep C acnes contamination and potentially decrease the risk of periprosthetic joint infection.

OBJECTIVES: To provide insight into the characteristics, layer locations, and corporal distribution of the granulomatous reactions to cosmetic fillers. METHODS: An international retrospective multicentric study was performed in centers that scan complications of cosmetic fillers. Inclusion criteria were patients with previous injections of known cosmetic fillers confirmed by ultrasound and ultrasonographic features of granulomatous reactions such as hypoechoic nodules, pseudonodules, or hypoechoic tissue surrounding the deposit regions. The ultrasound studies followed the published guidelines for performing dermatologic ultrasound examinations. RESULTS: A total of 240 cases met the criteria. The leading fillers previously injected were 50.4% hyaluronic acid, 18.8% poly-L-lactic acid, 8.3% polymethylmethacrylate, 6.3% calcium hydroxyapatite, and 3.8% silicone oil. The main regions of granulomas were the lower lid, infraorbital, and medial cheek in 41.7%, the perioral region and lips in 19.2%, the lateral jaw and cheek in 14.6%, and the chin, pre-jowl, and medial jaw in 12.5%. The layers involved by the granulomatous reaction were hypodermis in 37.1%, the deep fat pad in 8.9%, the periosteum in 5.8%, the combination of hypodermis, deep fat pad, and muscle in 5.8%, and the combination of hypodermis, fascia, subfascial, deep fat pad, and muscle in 5.4%. The predominant corporal locations were the face, submandibular, and anterior neck, with 95.8% being 87.5% in the face. CONCLUSION: Ultrasound can provide valuable and detailed anatomical information supporting diagnosis and management as well as valuable insights into the granulomatous reactions to fillers.