Retrospective real-world study of Definisse threads for jaw line reshaping in Indian patients (REDEFINE JAW study)

Background

Thread lifting is a minimally invasive aesthetic procedure that lifts and realigns sagging tissue. Definisse double-needle threads are the latest fourth generation absorbable, monofilament, suspension barbed threads of synthetic origin with convergent bidirectional barbs. Definisse thread produces dual action; mechanical action gives a lifting effect and over a period, it promotes histological revitalizing action.

Objectives

To evaluate the real-world efficacy and safety of Definisse double-needle threads for lower facial lifting for jaw line reshaping in Indian patients.

Methods

This is an observational, retrospective study involving patients who underwent treatment for lower-face reshaping using Definisse double-needle 12 cm threads.

Results

Fifty patients with a mean age of 47.44 years were included in the study with an average follow-up of 5.14 months. All the patients have undergone Jawline Reshaping (JR) procedure, while 70% of patients also underwent Malar Reshaping (MR) technique simultaneously. Mean of Physician and Subject Global Aesthetic Improvement Scale (PGAIS and SGAIS) showed improvement immediately after the procedure (mean scores 2.82 and 2.7, respectively) and showed further improvement at the follow-up (3.72 and 3.58, respectively). Moreover, most of the patients immediately after the procedure rated the improvement in PGAIS and SGAIS as “much improved” compared to pre-procedure appearance (78% and 66%, respectively), while, at follow-up, 76% and 66% of the patients, respectively, rated “improved very much” compared to pre-procedure appearance.

Conclusion

Current study has demonstrated the effectiveness of the latest Definisse threads in Indian patients in performing tissue repositioning to provide a noticeable lifting effect. Procedure was also well tolerated and none of the patients developed serious complications.     

Haemodynamic Changes During Craniotomy Monitored By A Bioimpedance Plethysmographic Noninvasive Cardiac Output Monitor

Background  Profound cardiovascular changes may occur at various stages during a craniotomy. These changes require a detailed haemodynamic analysis including cardiac output. In the present study, we used a monitor based on electrical bioimpedance method for noninvasive cardiac output measurement. Methods  In 17 ASA I and II patients undergoing elective craniotomies for supratentorial tumours, the following haemodynamic parameters were measured noninvasively: heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), stroke volume (SV), cardiac output (CO) and systemic vascular resistance (SVR). Haemodynamic changes in response to the following events were studied: (a) induction of anaesthesia with thiopentone, (b) 15 min of air–O₂–isoflurane anaesthesia, (c) infiltration of the scalp with lidocaine adrenaline mixture, and (d) change of inspired gas mixture to N₂O–O₂–isoflurane. Results  HR increased (P < 0.001) and SV decreased (P < 0.001) while CO remained unchanged, one min after administration of thiopentone. After 15 min of isoflurane anaesthesia, HR increased (P < 0.001) and, SBP (P = 0.02), DBP (P = 0.002) and SV (P = 0.003) decreased significantly without change in CO. Three minutes after infiltration of the scalp with lidocaine–adrenaline mixture, there was an increase in SBP (P = 0.001), DBP (P = 0.007), SV (P = 0.007) and CO (P = 0.001) and a decrease in SVR (P < 0.001). Addition of nitrous oxide (60%) to the inspired gas mixture decreased SBP (P = 0.003) and DBP (P = 0.001) with a trend for decrease in CO (P < 0.1). The changes recorded in the present study conform to those that have been documented earlier by using invasive monitoring. Conclusion  Bioimpedance plethysmography is a useful noninvasive technique for monitoring and detailed analysis of the rapidly changing systemic haemodynamics during a craniotomy. The device could be useful for investigating important haemodynamic changes in specific neurosurgical settings. Ali Z, Umamaheswara Rao GS, Jaganath A. Haemodynamic changes during craniotomy monitored by a bioimpedance plethysmographic noninvasive cardiac output monitor.     

Sonographic appearance of heterotopic pregnancy with ruptured ectopic tubal pregnancy

Heterotopic pregnancy, ie, combined intrauterine and extrauterine (ectopic) pregnancy, is a rare clinical entity that may present with acute abdominal catastrophy. Most of cases reported in literature are a consequence of medical or surgical interventions like assisted reproductive techniques, tubal surgeries, intrauterine contraceptive devices, or pelvic inflammatory disease. Heterotopic pregnancy occurring spontaneously is extremely uncommon. We describe the sonographic appearance of spontaneous heterotopic pregnancy with ruptured ectopic tubal pregnancy. © 2010 Wiley Periodicals, Inc. J Clin Ultrasound, 2010