Daily Cosmetic Research Analysis
A single-center randomized controlled trial showed that adding intralesional bleomycin to low-dose propranolol markedly improved regression of infantile hemangioma with comparable safety. A large retrospective cohort comparing robotic versus open thyroidectomy for differentiated thyroid cancer found better long-term recurrence-free survival, fewer complications, and superior quality-of-life and cosmetic outcomes with robotic surgery. A prospective comparative study in Thai schoolgirls documented
Summary
A single-center randomized controlled trial showed that adding intralesional bleomycin to low-dose propranolol markedly improved regression of infantile hemangioma with comparable safety. A large retrospective cohort comparing robotic versus open thyroidectomy for differentiated thyroid cancer found better long-term recurrence-free survival, fewer complications, and superior quality-of-life and cosmetic outcomes with robotic surgery. A prospective comparative study in Thai schoolgirls documented very low cure rates with over-the-counter pediculicide shampoos, supporting emerging insecticide resistance and the need for updated guidelines.
Research Themes
- Combination therapy optimization for infantile hemangioma
- Robotic surgery and long-term oncologic and cosmetic outcomes
- Public health response to insecticide resistance in consumer pediculicides
Selected Articles
1. Propranolol (1 mg/kg/day) with intralesional bleomycin versus propranolol monotherapy for infantile hemangioma: a randomized controlled trial.
In 260 infants with infantile hemangioma, adding monthly intralesional bleomycin to low-dose propranolol significantly increased the 6-month excellent response rate versus propranolol alone and doubled complete regression rates. Early atrophy within 24 hours and improvements in color and volume were greater with combination therapy, with a comparable safety profile.
Impact: This randomized trial provides high-level evidence supporting a practical combination regimen that accelerates tumor regression and improves cosmetic outcomes while maintaining safety in infants.
Clinical Implications: For infants requiring systemic therapy for IH, consider adding intralesional bleomycin to low-dose propranolol to enhance early and overall responses and optimize cosmetic outcomes, with appropriate monitoring.
Key Findings
- Excellent therapeutic response at 6 months: 77.69% (combination) vs 50.00% (monotherapy); P < 0.001
- Complete regression: 33.07% vs 15.38%; P = 0.001
- Greater early response with more pronounced tumor atrophy within 24 hours; P < 0.001
- Significant improvements in color scores and tumor volume reduction from baseline (P < 0.001)
- Comparable safety profile between groups in this trial
Methodological Strengths
- Prospective randomized controlled design with adequate sample size (n=260)
- Predefined primary endpoint with statistically robust differences
Limitations
- Single-center study limits generalizability
- Blinding and allocation concealment are not detailed; short (6-month) primary follow-up
Future Directions: Multicenter, blinded RCTs with standard-dose comparators and longer follow-up should assess durability, relapse, optimal dosing intervals, and safety, including VSS and functional outcomes.
2. Long-term outcomes of robotic vs. open thyroidectomy for differentiated thyroid cancer: efficacy, safety and quality of life.
In a 6,249-patient retrospective cohort, open thyroidectomy had higher recurrence, hypoparathyroidism, and permanent hoarseness rates than robotic thyroidectomy. Robotic surgery provided better long-term recurrence-free survival after 100 months and superior patient-reported quality-of-life and scar outcomes.
Impact: This large-scale, long-term comparative analysis informs surgical decision-making by linking robotic approaches to improved oncologic control, fewer complications, and better patient-reported outcomes including cosmetic results.
Clinical Implications: For eligible differentiated thyroid cancer patients, robotic thyroidectomy may be prioritized when feasible, given lower complication rates, improved long-term RFS, and superior scar/QOL metrics; careful patient selection and surgeon expertise remain critical.
Key Findings
- Recurrence rate: 2.29% (open) vs 1.82% (robotic); P = .02
- Higher transient and permanent hypoparathyroidism in open surgery; P < .001
- Higher permanent hoarseness in open surgery; P = .002
- RFS probability declined markedly after 100 months in the open group, falling below robotic; P = .027
- Robotic group had better SF-36 domains and SCAR-Q scores; P < .001
Methodological Strengths
- Very large sample size with decade-long period and long-term follow-up
- Use of validated patient-reported outcome measures (SF-36, SCAR-Q) alongside clinical endpoints
Limitations
- Retrospective, non-randomized design with potential selection and confounding biases
- Learning curve and surgeon/center effects not fully controlled
Future Directions: Prospective multicenter studies with risk adjustment and cost-effectiveness analyses should validate long-term oncologic, functional, and cosmetic benefits of robotic thyroidectomy across disease extents.
3. Treatment failure of over-the-counter pediculicide shampoos in Thai schoolgirls: Evidence of insecticide resistance.
In a prospective three-arm comparison of 135 Thai schoolgirls, cure rates at day 14 were low: 42.22% for carbaryl, 24.44% for Stemona extract, and 6.67% for permethrin after two applications. Findings align with insecticide resistance trends and call for alternatives (e.g., ivermectin, abametapir, dimeticone), guideline updates, and resistance surveillance.
Impact: Provides pragmatic field evidence of poor real-world effectiveness of common OTC pediculicides, informing public health policy and consumer guidance in endemic settings.
Clinical Implications: Clinicians and schools should anticipate low cure rates with common OTC pediculicides and consider alternative agents/mechanisms, coordinated screening, simultaneous treatment, and local resistance surveillance.
Key Findings
- Cure at day 14: carbaryl 42.22%, Stemona 24.44%, permethrin 6.67% (n=45 per group)
- Two applications were administered on day 0 and day 7 per manufacturer instructions
- No side effects reported; none of the shampoos achieved complete eradication
- Outcomes were especially poor in heavy infestations
- Findings support emerging resistance and recommend alternatives (ivermectin, abametapir, dimeticone) and updated guidelines
Methodological Strengths
- Prospective allocation into three parallel treatment groups with equal sample sizes
- Standardized application schedule and objective comb-based cure assessment at day 14
Limitations
- Non-randomized design with potential selection and performance biases
- Short follow-up and single province setting limit generalizability; resistance not genotyped
Future Directions: Randomized trials comparing alternative mechanisms (ivermectin, abametapir, dimeticone) with molecular resistance profiling and cost-effectiveness analyses in school-based programs.