A systematic review of botulinum toxin as a treatment for Raynaud's disease secondary to scleroderma.

Raynaud's phenomenon (RP) is a vasospastic disorder that affects the small blood vessels in the extremities such as the hands, feet, fingers or toes. It is a debilitating condition that can severely impact the patient's quality of life. Botulinum toxin (BTX) has been examined as a treatment option for RP, but its effect has been inconclusive.

Clinical, Preclinical, and Educational Applications of Robotic-Assisted Flap Reconstruction and Microsurgery: A Systematic Review.

Introduction: Microsurgery and super-microsurgery allow for highly technical reconstructive surgeries to be performed, with repairs of anatomical areas of less than 1 mm. Robotic-assisted surgery might allow for further advances within microsurgery, providing higher precision, accuracy, and scope to operate in previously inaccessible anatomical areas. However, robotics is not well-established within this field.

A systematic review of outcome measures evaluating treatment efficacy in vulval lichen sclerosus and evaluation of patients' priorities.

Vulval lichen sclerosus (VLS) is an inflammatory skin disease characterised by itching, apareunia, loss of vulval architecture and scarring. Heterogeneity in outcome reporting precludes comparison between treatments. This study aimed to systematically review outcome measures used to evaluate the efficacy of VLS treatments and present patients' treatment priorities.

Fat Grafting and Adipose Stem Cells for Facial Systemic Sclerosis: A Systematic Review of the Literature.

Background: Orofacial modifications occurring in systemic sclerosis are detrimental for patients, but the therapeutic options are limited.

Objectives: This systematic review aimed to perform an up-to-date appraisal of the literature focusing on fat grafting and other adipose stem cell-based therapies for the treatment of facial systemic sclerosis, determining its efficacy and safety, and investigating the current practice for treatment optimization.

Methods: The review was prospectively registered in PROSPERO (CRD42021286268) and followed the PRISMA principles.

The emerging role of robotics in plastic and reconstructive surgery: a systematic review and meta-analysis.

The role of robotics has grown exponentially. There is an active interest amongst practitioners in the transferability of the potential benefits into plastic and reconstructive surgery; however, many plastic surgeons report lack of widespread implementation, training, or clinical exposure. We report the current evidence base, and surgical opportunities, alongside key barriers, and limitations to overcome, to develop the use of robotics within the field.

Exploring Anti-Fibrotic Effects of Adipose-Derived Stem Cells: Transcriptome Analysis upon Fibrotic, Inflammatory, and Hypoxic Conditioning.

Autologous fat transfers show promise in treating fibrotic skin diseases, reversing scarring and stiffness, and improving quality of life. Adipose-derived stem cells (ADSCs) within these grafts are believed to be crucial for this effect, particularly their secreted factors, though the specific mechanisms remain unclear. This study investigates transcriptomic changes in ADSCs after in vitro fibrotic, inflammatory, and hypoxic conditioning.

Outcomes in facial transplantation - a systematic review.

Facial transplantations have become a clinical reality as the last reconstructive option in severely disfigured patients. To date, clinical outcomes remain unclear. The purpose of this paper was to analyse the outcomes in facial transplantation (FT) and determine the risks and benefits of FT based on short- and long-term outcomes.

Correlation between oral and oropharyngeal resection subsites and impact of reconstruction on speech and swallowing function in head and neck cancer patients: A systematic review.

This review aims to provide a correlation between oral and oropharyngeal subsites and type of reconstruction used in the management of head and neck cancer patients. A literature search of PubMed, Embase and Web of Science was conducted. All study types describing long-term speech and swallow outcomes of adults following head and neck oncological reconstruction, which used a subsite classification, were included.

Scarring and Skin Fibrosis Reversal with Regenerative Surgery and Stem Cell Therapy.

Skin scarring and fibrosis affect millions of people worldwide, representing a serious clinical problem causing physical and psychological challenges for patients. Stem cell therapy and regenerative surgery represent a new area of treatment focused on promoting the body's natural ability to repair damaged tissue. Adipose-derived stem cells (ASCs) represent an optimal choice for practical regenerative medicine due to their abundance, autologous tissue origin, non-immunogenicity, and ease of access with minimal morbidity for patients.

Exploring the mechanisms behind autologous lipotransfer for radiation-induced fibrosis: A systematic review.

Aim: Radiation-induced fibrosis is a recognised consequence of radiotherapy, especially after multiple and prolonged dosing regimens. There is no definitive treatment for late-stage radiation-induced fibrosis, although the use of autologous fat transfer has shown promise. However, the exact mechanisms by which this improves radiation-induced fibrosis remain poorly understood.

A comparison of commercially available synthetic skin substitutes for surgical simulation training.

Objective: Simulation training provides an important opportunity to accelerate surgical skills acquisition whilst safeguarding patients. This study compares the suitability of different synthetic skin substitutes for use in surgical simulation training.

Design: Data was collected for eight commercially available synthetic skin substitutes and included cost, delivery time, subjective assessment of fidelity by surgeons and trainees, and objective comparison with the biomechanics of human skin was made through cutometry and durometry measurements.

The efficacy of negative-pressure wound therapy for head and neck wounds: A systematic review and update.

Despite the established benefits of negative-pressure wound therapy (NPWT) in various wound healing contexts, its application in head and neck surgical cases remains under-explored. This study aimed to systematically review its effectiveness, safety, and comparative efficacy. Thirty-one studies from a systematic literature search were identified and analyzed for wound healing response, overall success rate, improvements compared to conventional wound care, and variation in pressure settings, treatment lengths, and dressing change frequency.

Application of fluorescence lifetime imaging microscopy to monitor glucose metabolism in pancreatic islets .

Glucose stimulated insulin secretion is mediated by glucose metabolism via oxidative phosphorylation generating ATP that triggers membrane depolarization and exocytosis of insulin. In stressed beta cells, glucose metabolism is remodeled, with enhanced glycolysis uncoupled from oxidative phosphorylation, resulting in the impaired glucose-mediated insulin secretion characteristic of diabetes. Relative changes in glycolysis and oxidative phosphorylation can be monitored in living cells using the 3-component fitting approach of fluorescence lifetime imaging microscopy (FLIM).

Single-Cell Analysis of ADSC Interactions with Fibroblasts and Endothelial Cells in Scleroderma Skin.

Adipose-derived stem cells (ADSCs) as part of autologous fat grafting have anti-fibrotic and anti-inflammatory effects, but the exact mechanisms of action remain unknown. By simulating the interaction of ADSCs with fibroblasts and endothelial cells (EC) from scleroderma (SSc) skin in silico, we aim to unravel these mechanisms. Publicly available single-cell RNA sequencing data from the stromal vascular fraction of 3 lean patients and biopsies from the skin of 10 control and 12 patients with SSc were obtained from the GEO and analysed using R and Seurat.

Efficacy of IAPP suppression in mouse and human islets by GLP-1 analogue conjugated antisense oligonucleotide.

Insulin resistance is the major risk factor for Type 2 diabetes (T2D). In vulnerable individuals, insulin resistance induces a progressive loss of insulin secretion with islet pathology revealing a partial deficit of beta cells and islet amyloid derived from islet amyloid polypeptide (IAPP). IAPP is co-expressed and secreted with insulin by beta cells, expression of both proteins being upregulated in response to insulin resistance.

Executive Involvement in Governing Boards and Hospital and Health System Performance.

Governing boards and executive leaders play important roles ensuring that their organizations work toward their missions and maintain their visions, while also meeting compliance and performance goals. The level of executive involvement in hospital governing boards varies across organizations, with little evidence to suggest whether and to what degree executive involvement influences hospital performance. The aim of this study is to determine the influence of executive involvement in governance on health system performance.

The intraoperative use of augmented and mixed reality technology to improve surgical outcomes: A systematic review.

Background: This systematic review aims to critically appraise the intraoperative use of augmented and mixed reality technology to improve surgical outcomes.

Method: A literature search of PubMed, Scopus, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and WHO ICTRP was performed in accordance with Cochrane Handbook for Systematic Reviews of Interventions.

Portable three-dimensional imaging to monitor small volume enhancement in face, vulva, and hand: A comparative study.

Multiple handheld three-dimensional (3D) systems are available on the market, but data regarding their use in detecting small volumes are limited. The aim of this study was to compare different portable 3D technologies in detecting small volumetric enhancement on a mannequin model and a series of patients. Five portable 3D systems (Artec Eva, Crisalix, Go!Scan, LifeViz Mini, and Vectra H1) were tested in a controlled environment with standardised volumes and in a clinical setting with patients undergoing small volume fat grafting to face, vulva, and hand.

Ectopic extramammary Paget's disease of the abdominal wall with abdominoplasty reconstruction.

Ectopic extramammary Paget's disease describes an exceedingly rare intraepithelial adenocarcinoma arising within non-apocrine tissues. We present a case report of E-EPMD arising on the lower abdomen without underlying secondary malignancy in a 56-year-old female patient. We performed a wide local excision of the lesion with subsequent mini abdominoplasty reconstruction.

A transparent low intensity pulsed ultrasound (LIPUS) chip for high-throughput cell stimulation.

We report an on-chip platform for low-intensity pulsed ultrasound (LIPUS) stimulation of cells directly cultured on a biocompatible surface of a transparent ultrasound transducer (TUT) fabricated using lithium niobate. The high light transmittance (>80%) and compact size (3 mm × 3 mm × 2 mm) of TUTs allowed easy integration with powerful optical microscopy techniques with no additional acoustic coupling and risk for contamination. TUTs were excited with varying acoustic excitation parameters (voltage amplitude and duty cycle) and resulting live cell calcium signaling was simultaneously imaged using time-lapse confocal microscopy, while the temperature change was measured by a thermocouple.

IAPP-induced beta cell stress recapitulates the islet transcriptome in type 2 diabetes.

Aims/hypothesis: Type 2 diabetes is characterised by islet amyloid and toxic oligomers of islet amyloid polypeptide (IAPP). We posed the questions, (1) does IAPP toxicity induce an islet response comparable to that in humans with type 2 diabetes, and if so, (2) what are the key transcriptional drivers of this response?

Methods: The islet transcriptome was evaluated in five groups of mice: beta cell specific transgenic for (1) human IAPP, (2) rodent IAPP, (3) human calpastatin, (4) human calpastatin and human IAPP, and (5) wild-type mice. RNA sequencing data was analysed by differential expression analysis and gene co-expression network analysis to establish the islet response to adaptation to an increased beta cell workload of soluble rodent IAPP, the islet response to increased expression of oligomeric human IAPP, and the extent to which the latter was rescued by suppression of calpain hyperactivation by calpastatin.