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OBJECTIVES: To describe characteristics of women with aesthetically ideal buttocks and differentiate them from women with normal buttocks. METHODS: Case-control study comparing anatomy of women with ideal buttocks (buttocks models) to women with normal buttocks using magnetic resonance images, anthropometric measurements and photography. RESULTS: Comparing to normal women, buttocks models have a narrower waist, narrower iliac crest, wider C point, wider hips and bigger and thicker gluteus maximus muscle (GMM). A bigger GMM adds more projection to the C point, point of maximum projection in the lateral view is 2.7 cm higher than the pubic bone. The amount of subcutaneous fat was equal in models and controls. CONCLUSIONS: Our study provides new knowledge regarding the tridimensional aspects of the beauty of the buttocks area. A beautiful buttock is a conjunction of adequate bony shape, muscle development, subcutaneous fat layer, and tight skin. Comparing to normal women, buttocks models have a narrower waist, narrower iliac crest, wider C point, wider hips and bigger and thicker Gluteus Maximus Muscle. Accurate understanding of the aesthetic goals in a given patient can guide surgical technique. 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 .
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Imageamento por Ressonância Magnética , Humanos , Feminino , Nádegas/diagnóstico por imagem , Nádegas/cirurgia , Estudos de Casos e Controles , Antropometria , EstéticaRESUMO
The most distinguished feature of the female silhouette is the buttock. As such, the Brazilian Butt Lift (BBL) has become the most popular plastic surgery procedures in recent years. Despite the popularity of this buttock reshaping and augmentation procedure, there remains no prevailing standard for evaluating, planning surgical design, and objectifying buttock size and shape outcomes. In fact, we have observed a wide range of preferred buttock size and shapes among our patients. We have previously published the BBL assessment tool that serves to guide patient communication of their preferred buttock size and shape. In this study, we demonstrate how the BBL assessment tool can serve to optimize Brazilian Buttock Lift results. We present 25 case studies of how the BBL assessment tool can serve to optimize BBL results by providing a guide for evaluation, surgical design, and objectification of outcomes.Level of Evidence IV Therapeutic study. 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 .
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Procedimentos de Cirurgia Plástica , Humanos , Feminino , Nádegas/cirurgia , Brasil , EstéticaRESUMO
For decades, aesthetic medical procedures have sought to improve patient appearance, comfort, and self-confidence. In more recent years, a growing interest in body contouring cosmetic procedures has emerged, in large part due to increased transparency in procedures and improved outcomes with minimally invasive procedures. Notably, several biostimulatory fillers have emerged as a suitable treatment modality due to their relatively low cost, low pain, short downtime, high tunability, and sustained biostimulatory effect. One volumizing biostimulatory filler, Radiesse® (Merz Aesthetics, Frankfurt, Germany), consists of calcium hydroxylapatite microspheres suspended in a carboxymethyl cellulose gel. When injected, Radiesse immediately volumizes the injection site and initiates neocollagenesis and neoelastogenesis. One technique, the Bella Vida Instant Brazilian Butt Lift (BBL)™, is a fast, safe, and minimally invasive alternative to surgical gluteal augmentation that accomplishes morphological remodeling, increases volumization, and improves shape and patient satisfaction. This technical report provides the clinical basis, materials, and methods for implementing the Bella Vida Instant BBL™ in aesthetic practices.
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The ability of tumor cells to evade the immune system is one of the main challenges we confront in the fight against cancer. Multiple strategies have been developed to counteract this situation, including the use of immunostimulant molecules that play a key role in the anti-tumor immune response. Such a response needs to be tumor-specific to cause as little damage as possible to healthy cells and also to track and eliminate disseminated tumor cells. Therefore, the combination of immunostimulant molecules and tumor-associated antigens has been implemented as an anti-tumor therapy strategy to eliminate the main obstacles confronted in conventional therapies. The immunostimulant 4-1BBL belongs to the tumor necrosis factor (TNF) family and it has been widely reported as the most effective member for activating lymphocytes. Hence, we will review the molecular, pre-clinical, and clinical applications in conjunction with tumor-associated antigens in antitumor immunotherapy, as well as the main molecular pathways involved in this association.
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Ligante 4-1BB/imunologia , Antígenos de Neoplasias/imunologia , Imunidade Inata , Ativação Linfocitária , Proteínas de Neoplasias/imunologia , Neoplasias/imunologia , Animais , Humanos , Neoplasias/patologia , Neoplasias/terapiaRESUMO
Human papillomaviruses (HPVs) are responsible for about 25% of cancer cases worldwide. HPV-16 E7 antigen is a tumor-associated antigen (TAA) commonly expressed in HPV-induced tumors; however, it has low immunogenicity. The interaction of 4-1BBL with its receptor induces pleiotropic effects on innate, adaptive, and regulatory immunity and, if fused to TAAs in DNA vaccines, can improve the antitumor response; however, there is low transfection and antitumor efficiency. Oncolytic virotherapy is promising for antitumor gene therapy as it can be selectively replicated in tumor cells, inducing cell lysis, and furthermore, tumor cell debris can be taken in by immune cells to potentiate antitumor responses. In this study, we expressed the immunomodulatory molecule SA-4-1BBL fused to E7 on an oncolytic adenovirus (OAd) system. In vitro infection of TC-1 tumor cells and NIH-3T3 non-tumor cells with SA/E7/4-1BBL OAd demonstrated that only tumor cells are selectively destroyed. Moreover, protein expression is targeted to the endoplasmic reticulum in both cell lines when a signal peptide (SP) is added. Finally, in an HPV-induced cancer murine model, the therapeutic oncolytic activity of OAd can be detected, and this can be improved when fused to E7 and SP.
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BACKGROUND: The BAAPS advice against Brazilian butt lift (BBL) surgery in the UK was set in October 2018. A Delphi study conducted by BAAPS highlighted the importance of defining current practice and perceptions amongst UK surgeons, as this is currently unknown. OBJECTIVES: To evaluate BAAPS members' current practice and perceptions around BBL surgery to ensure patient safety and propose better recommendations. METHODS: A BAAPS-commissioned survey was emailed to all BAAPS members through an on-line link. The survey collected quantitative and qualitative information in several domains. RESULTS: This survey received a 44% response rate. Of 102 respondents, 32 surgeons undertook BBL surgery before the BAAPS advice to halt it. There was a wide variation in actual fat volumes injected, and in perceptions of what constituted a small or large volume. Virtually all respondents (96.9%) performed only subcutaneous fat injections. There were differences in fat harvest techniques. The majority (66.7%) felt that BAAPS should maintain its recommendation against undertaking BBL surgery until further data became available. Nearly a quarter of 102 respondents (20.6%) had been treated for BBL complications, the majority as a result of surgical tourism. CONCLUSIONS: The survey provides member-reported perception and experience with regard to BBL surgery in the UK. The demand for BBL surgery and its provision should be reassessed in the UK. This information will be analysed with further national and international data to better define and shape the scope of the safety of BBL surgery in the UK. BAAPS will use such data towards the production of future guidance and support for surgeons and patients.
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Contorno Corporal/métodos , Nádegas/cirurgia , Procedimentos de Cirurgia Plástica , Complicações Pós-Operatórias/cirurgia , Gordura Subcutânea/transplante , Cirurgiões/estatística & dados numéricos , Adulto , Atitude do Pessoal de Saúde , Feminino , Humanos , Injeções Subcutâneas/métodos , Padrões de Prática Médica , Procedimentos de Cirurgia Plástica/efeitos adversos , Procedimentos de Cirurgia Plástica/métodos , Percepção Social , Inquéritos e Questionários , Coleta de Tecidos e Órgãos/métodos , Reino UnidoRESUMO
BACKGROUND: This study aims to understand how sociodemographic factors influence perceptions of "Brazilian Butt Lift" (BBL), the cosmetic procedure with the highest reported mortality rate, among adult women. We also investigate whether education about risks changes willingness to receive this procedure. METHODS: A Qualtrics© survey including education about BBL was administered on Amazon Mechanical Turk, with inclusion criteria of female sex. RESULTS: Survey data from 489 female participants were included. 78.1% of participants found the BBL mortality rate to be higher than expected. 70.1% of the original 177 willing or neutral participants became unwilling to undergo a BBL after education. Multivariate logistic regression indicated that individuals who were more willing to undergo BBL after education were individuals who have a diagnosis of body dysmorphic disorder (OR 60.5, p = 0.02) or have an acquaintance who received a BBL (OR 230.2, p < 0.01). CONCLUSIONS: Overall, survey participants were less willing to undergo BBL after learning its risks, indicating the critical role of patient education during informed consent. Additionally, individuals who are unhappy with their body shape, or who feel cultural or social pressure to attain a certain body shape, may accept higher levels of risk to improve their looks, suggesting patient motivation for the procedure may limit even the most effective informed consent process. In light of these findings, the surgical community may consider regulating the BBL procedure and improving safety using evidence-based risk reduction techniques. Ensuring that patients fully understand the risks associated with the BBL procedure is critical for both surgeon and patient. LEVEL OF EVIDENCE V: 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 .
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Transtornos Dismórficos Corporais , Tecido Adiposo , Adulto , Brasil , Feminino , Humanos , Percepção , RecompensaRESUMO
The SA-4-1BBL, an oligomeric novel form of the natural ligand for the 4-1BB co-stimulatory receptor of the tumor necrosis factor (TNF) superfamily, as a recombinant protein has potent pleiotropic effects on cells of innate, adaptive, and regulatory immunity with demonstrated therapeutic efficacy in several tumor models. However, the production of soluble form of SA-4-1BBL protein and quality control is time and resource intensive and face various issues pertinent to clinical development of biologics. The present study sought to take advantage of the simplicity and translatability of DNA-based vaccines for the production and delivery of SA-4-1BBL for cancer immune prevention and therapy. A chimeric HPV-16 E7 DNA vaccine (SP-SA-E7-4-1BBL) was constructed that contains the signal peptide (SP) of calreticulin (CRT), streptavidin (SA) domain of SA-4-1BBL, HPV-16 E7 double mutant gene, and the extracellular domain of mouse 4-1BBL. Immunization by gene gun with SP-SA-E7-4-1BBL induced greater prophylactic as well as therapeutic effects in C57BL/6 mice against TC-1 tumor model compared with immunization with E7wt, SP-SA-4-1BBL or reference-positive control CRT-E7wt. The therapeutic efficacy of the DNA vaccine was associated with increased frequency of E7-specific T cells producing interferon (IFN)-γ. Overall, our data suggest that this DNA-based vaccine strategy might represent a translational approach because it provides a simpler and versatile alternative to a subunit vaccine based on SA-4-1BBL and E7 proteins.
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Las dermatitis bacterianas o piodermas en caninos son ocasionadas por microorganismos patógenos, de los cuales el Staphylococcus intermedius es el más frecuente. Los tratamientos empíricos de este grupo de enfermedades permiten la proliferación de cepas resistentes de importancia en salud pública como es el caso del S. aureus. De igual forma, el riesgo de zoonosis reversa a partir de mascotas portadoras de cepas resistentes crea un serio problema de salud pública que requiere vigilancia epidemiológica. El objetivo de la investigación fue aislar e identificar bioquímicamente los microorganismos presentes en infecciones de piel en caninos; para esto se obtuvieron las muestras de caninos con problemas dermatológicos, y se identificaron los microorganismos bacterianos involucrados utilizando el kit de identificación rápida BBL Crystal para grampositivos. Los resultados obtenidos demostraron que el 80% de los aislamientos correspondieron a S. intermedius. Sin embargo, es necesario realizar estudios moleculares para relacionar la severidad de las lesiones dermatológicas con la identificación de los estafilococos presentes en el pioderma, y así establecer medidas de control, tratamiento y profilaxis...
Bacterial dermatitis or pyoderma in dogs are caused by pathogenic microorganisms, among which Staphylococcus intermedius is the most common. The empirical treatment of this group of diseases allows the proliferation of resistant strains that are significant for public health in the case of S. aureus. Similarly, the risk of reverse zoonoses from pet carriers of resistant strains creates a serious public health issue that requires epidemiological surveillance. The objective of the research was the biochemical isolation and identification of the microorganisms present in skin infections in dogs; samples were taken from dogs with skin problems for this purpose, and the bacterial organisms involved were identified by using the BBL Crystal Rapid Gram-Positive ID Kit. Results showed that 80% of the isolates corresponded to S. intermedius. However, molecular studies are required to relate the severity of skin lesions with the identification of staphylococci present in pyoderma, and thus be able to establish control, treatment and prophylaxis measures...
As dermatites bacterianas ou piodermites em caninos são ocasionadas por micro-organismos patógenos, dos quais o Staphylococcus intermedius é o mais frequente. Os tratamentos empíricos deste grupo de doenças permitem a proliferação de cepas resistentes de importância em saúde pública como é o caso do S. aureus. De igual forma, o risco de zoonose reversa a partir de mascotes portadores de cepas resistentes cria um sério problema de saúde pública que requer vigilância epidemiológica. O objetivo da pesquisa foi isolar e identificar bioquimicamente os micro-organismos presentes em infecções de pele em caninos; para isto se obtiveram as mostras de caninos com problemas dermatológicos, e se identificaram os micro-organismos bacterianos envolvidos utilizando o kit de identificação rápida BBL Crystal para Gram positivos. Os resultados obtidos demonstraram que 80% dos isolamentos corresponderam a S. intermedius. Entretanto, é necessário realizar estudos moleculares para relacionar a severidade das lesões dermatológicas com a identificação dos estafilococos presentes na piodermite, e assim estabelecer medidas de controle, tratamento e profilaxia...
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Cães , Bioquímica , Cães , Pioderma , ZoonosesRESUMO
The objective of the current study was to compare two rapid methods, the BBL Mycobacteria Growth Indicator Tube (MGIT TM) and Biotec FASTPlaque TB TM (FPTB) assays, with the conventional Löwenstein-Jensen (LJ) media assay to diagnose mycobacterial infections from paucibacillary clinical specimens. For evaluation of the clinical utility of the BBL MGIT TM and FPTB assays, respiratory tract specimens (n = 208), with scanty bacilli or clinically evident, smear negative cases and non-respiratory tract specimens (n = 119) were analyzed and the performance of each assay was compared with LJ media. MGIT and FPTB demonstrated a greater sensitivity (95.92 percent and 87.68 percent), specificity (94.59 percent and 98.78 percent), positive predictive value (94.91 percent and 99.16 percent) and negative predictive value (96.56 percent and 90.92 percent), respectively, compared to LJ culture for both respiratory tract and non-respiratory tract specimens. However, the FPTB assay was unable to detect nontuberculous mycobacteria and few Mycobacterium tuberculosis complex cases from paucibacillary clinical specimens. It is likely that the analytical sensitivity of FPTB is moderately low and may not be useful for the direct detection of tuberculosis in paucibacillary specimens. The current study concluded that MGIT was a dependable, highly efficient system for recovery of M. tuberculosis complexes and nontuberculous mycobacteria from both respiratory and non-respiratory tract specimens in combination with LJ media.
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Humanos , Líquido da Lavagem Broncoalveolar , Mycobacterium , Escarro , Tuberculose , Valor Preditivo dos Testes , Kit de Reagentes para Diagnóstico , Sensibilidade e Especificidade , Tuberculose Pulmonar , Tuberculose Pulmonar , TuberculoseRESUMO
Our aim was to construct a recombinant adenovirus co-expressing truncated human prostate-specific membrane antigen (tPSMA) and mouse 4-1BBL genes and to determine its effect on dendritic cells (DCs) generated from bone marrow suspensions harvested from C57BL/6 mice for which the effect of 4-1BBL on DCs is not clear, especially during DCs processing tumor-associated antigen. Replication deficient adenovirus AdMaxTM Expression System was used to construct recombinant adenovirus Ad-tPSMA-internal ribosome entry site-mouse 4-1BBL (Ad-tPSMA-IRES-m4-1BBL) and Ad-enhanced green fluorescent protein. Day 7 proliferating DC aggregates generated from C57BL/6 mice were collected as immature DCs and further mature DCs were obtained by lipopolysaccharide activated immature DCs. After DCs were exposed to the recombinant adenovirus with 250 multiplicity of infection, the expression of tPSMA and m4-1BBL proteins were detected by Western blot, and the apoptosis and phenotype of DCs were analyzed by flow cytometry. Cytokines (IL-6 and IL-12) in the supernatant were detected by enzyme-linked immunosorbent assay (ELISA). Proliferation of T cells was detected by allogeneic mixed lymphocyte reactions. The tPSMA and m4-1BBL proteins were expressed correctly. The apoptosis rate of DCs transfected with Ad-tPSMA-IRES-m4-1BBL was 14.6 percent, lower than that of control DCs. The expression of co-stimulatory molecules [CD80 (81.6 ± 5.4 percent) and CD86 (80.13 ± 2.81 percent)] up-regulated in Ad-tPSMA-IRES-m4-1BBL-pulsed DCs, and the level of IL-6 (3960.2 ± 50.54 pg/mL) and IL-12 (249.57 ± 12.51 pg/mL) production in Ad-tPSMA-IRES-m4-1BBL-transduced DCs were significantly higher (P < 0.05) than those in control DCs. Ad-tPSMA-IRES-m4-1BBL induced higher T-cell proliferation (OD450 = 0.614 ± 0.018), indicating that this recombinant adenovirus can effectively enhance the activity of DCs.