Daily Cosmetic Research Analysis

INTRODUCTION: Implant-based reconstruction is the most frequent procedure after mastectomy. Effective preoperative counseling and a thorough informed consent process are crucial for informing patients about oncologic surgery, reconstruction options, and expected cosmetic outcomes. Recent studies indicate that a multimedia video-assisted informed consent procedure may enhance patient information retention compared to traditional methods. This study aims to compare the conventional informed consent process, supplemented with a written informational brochure, to a multimedia video-assisted approach. MATERIALS AND METHODS: From January to June 2024, 265 consecutive breast cancer patients scheduled for mastectomy and implant-based reconstruction at the European Institute of Oncology in Milan, Italy, were enrolled in this controlled randomized prospective study. Of these, 200 patients completed evaluation questionnaires assessing information retention and anxiety. A six-minute video featuring simple schematic illustrations and automated text-to-speech narration in Italian was developed to enhance understanding of the risks, benefits, and alternatives of the surgical treatment. Patients were randomly assigned to two groups: Group A received the video presentation along with evaluation questionnaires via email, while Group B received only the questionnaires. RESULTS: Patients in the multimedia video-assisted group demonstrated significantly higher overall comprehension compared to those in the control group. Although scores from the Spielberger State/Trait Anxiety Inventory (STAI) and the Decisional Conflict Scale (DCS) indicated greater anxiety and decisional conflict in the standard group, these differences were not statistically significant. CONCLUSIONS: The multimedia video-assisted informed consent process is an effective tool for enhancing patient knowledge and awareness regarding implant-based breast reconstruction. This method improves information uptake and retention, suggesting its superiority over traditional communication techniques in preoperative counseling. These findings support the integration of multimedia resources in patient education to facilitate better-informed decision-making. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

INTRODUCTION: Allergic contact dermatitis (ACD) is a cutaneous inflammatory disorder mediated by allergen-specific memory T cells. Methylisothiazolinone (MI), a preservative widely used in industrial and cosmetic products and a component of Kathon CG, has led to a substantial rise in ACD cases. Despite increasing sensitization rates, the innate immune mechanisms and transcriptional responses induced by MI in the skin remain poorly understood. METHODS: Individuals with positive patch tests exclusively to MI were recruited at the Contact Dermatitis Clinic of Hospital das Clínicas (São Paulo). Participants were re-exposed to MI or saline, and skin biopsies were collected 48 hours later. Healthy MI-negative controls were also exposed to MI and saline. Histopathology and RNA-sequencing were performed. Differentially expressed genes (DEGs) were analyzed, and key findings were validated by qPCR and protein expression of IL-9 and IL-24. RESULTS: Two distinct MI-responsive groups emerged among ACD patients:ACD-A (high responders): pronounced histopathology (spongiosis, microvesicles). ACD-B (low responders): milder reactions with absence of spongiosis. In ACD-A, MI exposure resulted in 1,588 upregulated and 2,090 downregulated genes compared to ACD-B. DEGs were enriched for innate immune and inflammatory pathways, including IL-24, IL-9, IL-13, and NTRK1 (upregulated), while IL-37 and IL-18 were downregulated. Compared to MI-negative ACD controls, ACD-A showed 1,169 upregulated and 321 downregulated genes. qPCR confirmed increased NTRK1 and IL-9 expression and reduced IL-18 levels. IL-9 and IL-24 protein levels were higher in the dermal layer of ACD-A. DISCUSSION AND CONCLUSION: MI-sensitized individuals exhibit heterogeneous innate immune responses despite uniformly positive patch tests. IL-9, IL-24, and NTRK1 appear to play important roles in the heightened inflammatory response observed in high-responder individuals, while downregulation of IL-18 and IL-37 may contribute to impaired regulatory pathways. These findings highlight previously undescribed heterogeneity in MI-induced ACD and identify potential targets for better understanding disease pathogenesis.

INTRODUCTION: Lipedema is a chronic inflammatory disease characterized by symmetrical deposition of adipose tissue in the upper and lower limbs, disproportionate to the trunk. It primarily affects women. The objective of this study was to evaluate the effects of surgical treatment in patients with lipedema who are refractory to conservative management. METHODS: We conducted a systematic review and single-arm meta-analysis in accordance with PRISMA guidelines. Retrospective studies involving patients who underwent surgical treatment after failing clinical management were included. Means and proportions were pooled using the inverse variance method and logit transformations, and heterogeneity was assessed using the I RESULTS: We included 6 studies comprising 429 patients, with follow-up ranging from 6 months to 44 months. In this meta-analysis, surgical treatment with tumescent liposuction resulted in significant clinical improvements for patients with lipedema. The pooled mean preoperative pain score was 5.64 (95% CI: 3.67-8.69), which decreased to 1.19 (95% CI: 0.91-4.22) postoperatively. Sensitivity to touch or pressure was reduced from a preoperative mean of 5.77 (95% CI: 4.10-8.10) to 1.96 (95% CI: 1.17-3.29) after surgery. Swelling scores improved from 5.47 (95% CI: 3.73-8.02) preoperatively to 2.14 (95% CI: 1.31-3.48) postoperatively, while restriction of movement scores decreased from 3.76 (95% CI: 2.48-5.72) to 0.77 (95% CI: 0.36-1.64). CONCLUSION: The results of this single-arm meta-analysis, which included six studies and 429 patients with lipedema refractory to clinical treatment and undergoing surgical intervention, demonstrate that tumescent liposuction is associated with reductions in postoperative pain and edema, as well as improvements in cosmetic outcomes, quality of life, and mobility. The duration of follow-up was adequate to capture relevant clinical outcomes and adverse events. However, lipedema remains a condition that requires further high-quality studies to define the optimal therapeutic approach. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ."