Daily Cosmetic Research Analysis

Intralesional triamcinolone acetonide (TAC) remains the standard nonsurgical treatment for keloids but is limited by steroid-related adverse effects. Intralesional vitamin D has recently emerged as a potential alternative. This meta-analysis evaluated the comparative efficacy and safety of vitamin D versus TAC in keloid management. A systematic search of PubMed, Embase, and the Cochrane library identified randomized controlled trials comparing these treatments. The primary outcome was scar improvement assessed using validated scales, while secondary outcomes included lesion flattening and treatment-related adverse events. Four trials were included. TAC demonstrated superior efficacy in improving scar severity (MD = -9.72; 95% CI -17.41 to -2.02;

BACKGROUND: Although elective cosmetic surgery is associated with relatively low complication rates, adverse outcomes may still occur, particularly in patients with preexisting vulnerabilities. The modified frailty index-5 (mFI-5) is an established predictor of adverse outcomes across multiple surgical specialties, but its relevance and applicability in cosmetic surgery have not yet been elucidated. METHODS: Data from the American College of Surgeons National Surgical Quality Improvement Program (2008-2022) were used to identify adult female patients undergoing elective cosmetic procedures. Patients were stratified by mFI-5 score (0, 1, or > 1). Demographics, perioperative characteristics, and 30-day postoperative outcomes were compared. Multivariable logistic regression assessed associations between frailty and complications. Predictive performance was evaluated using receiver operating characteristic (ROC) analysis and threshold probability assessment. To compare the predictive value of the composite frailty score with its individual components, ridge-regularized logistic regression models were analyzed using stratified five-fold cross-validation. RESULTS: A total of 10,311 patients were included, of whom 88% had an mFI-5 score of 0, 11% had a score of 1, and 1% had a score greater than 1. Increasing frailty scores were associated with higher age and body mass index. Most patients underwent aesthetic breast surgery (65%), followed by abdominal contouring (29%) and combined breast-abdominal procedures (13%). Overall complication rates increased stepwise with frailty status (3% for mFI-5 = 0, 6% for mFI-5 = 1, and 12% for mFI-5 > 1; p < 0.001). Hypertension was the most prevalent frailty component, present in 87% of patients with mFI-5 = 1 and 99% of those with mFI-5 > 1, followed by diabetes. Other frailty components were uncommon. In multivariable analysis, an mFI-5 score greater than 1 independently predicted higher odds of overall complications and surgical complications, as well as increased readmission and unplanned reoperation. ROC analysis identified an mFI-5 score of 1 as a clinically relevant threshold beyond which complication risk increased. The composite mFI-5 demonstrated slightly superior discrimination and precision-recall performance compared with models based on individual comorbidities. CONCLUSION: Frailty, as measured by the mFI-5, was relatively rare among cosmetic surgery patients. Elevated mFI-5 scores were driven primarily by hypertension and/or diabetes rather than generalized physiological decline. Although patients with mFI-5 > 1 were significantly more likely to experience postoperative complications, the mFI-5 in this context might reflect comorbidity burden rather than true frailty. LEVEL OF EVIDENCE III: 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 .

The conjugation of biological drugs with polyethylenglycole is widely used to reduce their immunogenicity, thereby enhancing the safety and efficacy of the drugs. For instance, some extended half-life drugs for hemophilia A patients are PEGylated FVIII products. Unfortunately, it was observed that PEG itself, whether derived from PEGylated drugs or present in everyday products (such as cosmetics or medical devices) may induce the production of anti-PEG antibodies, resulting in hypersensitivity reactions and/or loss of efficacy of PEGylated drugs. There is therefore a demand for cost-effective and rapid point-of-care (POC) measurements. To this end, a POC device based on the principle of surface plasmon resonance (SPR) is here presented. The sensor chip is functionalized directly with PEG chains via thiol chemistry and inserted into a holder manufactured in 3D printing technology. The functionalization process has been optimized to recognize anti-PEG antibodies (both IgG and IgM isotypes) and characterized using X-ray Photoelectron Spectroscopy and contact angle measurements. Dose-response curves were obtained using commercially available antibodies, both in buffer solution and in diluted human serum, achieving a limit of detection in the nanomolar range. The reusability of the optical chip was also evaluated and, as proof of concept, plasma from control subjects and hemophilia A patients treated with PEGylated FVIII were measured, comparing the results with standard techniques such as a commercial SPR instrument and an enzyme-linked immunosorbent assay. The results were obtained within 15 min from tenfold diluted human plasma, paving the way for an easy-to-use, small-sized, portable, and low-cost POC device capable of detecting anti-PEG antibodies.