Study suggests average of 3 years of apparent age saved after facial plastic surgery, no consistent improvement in attractiveness

Main Category: Cosmetic Medicine / Plastic Surgery
Article Date: 01 Aug 2013 - 13:00 PDT Current ratings for:
Study suggests average of 3 years of apparent age saved after facial plastic surgery, no consistent improvement in attractiveness

A study suggests that after aesthetic facial plastic surgery the average number of apparent"years saved" (true age minus guessed age) was 3.1 years but there was only an insignificant increase in attractiveness scores, according to a report published by JAMA Facial Plastic Surgery, a JAMA Network publication.

Patients seek out aesthetic facial surgery to look younger and more attractive but there is minimal literature about the effect of the surgery on perceived age and attractiveness, according to the study background.

A. Joshua Zimm, M.D., of the Lenox Hill Hospital and Manhattan Eye, Ear & Throat Institute of North Shore-LIJ Health System, New York, and colleagues quantitatively evaluated the degree of perceived age change and improvement in attractiveness following surgical procedures.

Independent raters examined preoperative and postoperative photographs of 49 patients who underwent aesthetic facial plastic surgery between July 2006 and July 2010 at a private practice in Toronto, Canada. The photographs were shown to 50 blind raters. Patients in the study ranged in age from 42 to 73 years at the time of surgery with an average age of 57 years.

On average, raters estimated their patients' ages to be about 2.1 years younger than their chronological age before surgery and 5.2 years younger than their chronological age after surgery. The average overall years saved following surgery was 3.1 years, according to the results. There also was a small and insignificant increase in attractiveness scores in postprocedural photographs, the results indicate.

"In conclusion, the subjective nature of facial rejuvenation surgery presents a challenge in the assessment of successful results," the study concludes. "Given the limitations of the attractiveness component of this study as described herein, further investigation is warranted to verify these findings."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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JAMA Facial Plast Surg. Published online August 1, 2013. doi:10.1001/jamafacial.2013.268.

JAMA

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No improvement seen in HIV-associated lymphoma survival during the antiretroviral therapy era

Main Category: Lymphoma / Leukemia / Myeloma
Also Included In: HIV / AIDS
Article Date: 30 Jul 2013 - 0:00 PDT Current ratings for:
No improvement seen in HIV-associated lymphoma survival during the antiretroviral therapy era

Stable survival rates were observed for HIV-associated lymphoma patients during the antiretroviral therapy (ART) era in the US, according to a new study published in the Journal of the National Cancer Institute.

Studies have shown that HIV infection increases the risk of non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) and that incidence for many lymphoma types has not decreased in the ART era. Furthermore, lymphoma is the most frequent cancer-related cause of death among HIV-infected persons. However, trends in presentation and survival have not been investigated among HIV-associated lymphoma patients in routine care since the beginning of the ART era.

Satish Gopal, M.D., M.P.H., from the Program in Global Oncology at the Lineberger Comprehensive Cancer Center of the University of North Carolina, and colleagues compared differences in presentation and survival, across histologic subtypes and diagnosis years, among HIV-infected lymphoma patients. They also examined predictors of death in this population. Data from 476 HIV-associated lymphoma patients living in the US who were diagnosed with various types of lymphoma including HL, diffuse large B-cell lymphoma (DLBCL), Burkitt lymphoma (BL), primary central nervous system lymphoma (PCNSL), and other types of NHL, between 1996 and 2010 were analyzed using various statistical methods.

Their results demonstrate that HIV-associated lymphoma is heterogeneous and changing since the ART era began. Clinical presentations across the different lymphoma subtypes was highly variable during the study period (79 HL, 201 DLBCL, 56 BL, 54 PCNSL, and 86 with other NHL). Histologic shifts in the proportion of BL vs other NHL subtypes is increasing consistent with other reports. Data showed that more recently diagnosed patients were older and more likely to be male, of nonwhite/nonblack ethnicity (primarily Latino patients), to be men who have sex with men, and to have prior AIDS-related illness. They were also more likely to be on ART at lymphoma diagnosis with higher CD4 counts and better HIV control. The authors also report that more recent diagnosis year was not associated with decreased mortality and that 61.6% of patients with HIV-associated HL were alive 5 years after lymphoma diagnosis, compared with 50.0% for BL, 44.1% for DLBCL, 43.3% for other NHL, and 22.8% for PCNSL. Of note, lymphomas occurring on ART were associated with a doubling of mortality, which may suggest important biologic differences between tumors developing on and off ART, although these results require confirmation.

Gopal and colleagues conclude, "These results highlight an ongoing need to elucidate lymphoma biology and optimize treatments for this challenging population to reduce deaths from one of the leading causes of mortality in the modern ART era."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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In an accompanying editorial, Kieron Dunleavy, M.D., and Wyndham H. Wilson, M.D., Ph.D., from the Metabolism Branch of the Center for Cancer Research at the National Cancer Institute, state the findings reflect the shifting demographics of the HIV epidemic in the US. However, the shift towards more biologically favorable and curable types of lymphoma has not resulted in improved survival over the study period. They assert, "In conclusion, because HIV-associated lymphomas are potentially as curable as those arising in HIV-negative patients, it is critical that they be approached with the same care as HIV negative cases."

Journal of the National Cancer Institute

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Home improvement for those with poor health saves hospitals money

Adapting the homes of wheelchair users saved a London borough £30,000 per client. Photograph: Janine Wiedel Photolibrary / Ala/Alamy

Countless reports have called for greater collaborative working between the housing sector and health care providers, specifically with the view of creating lasting homes where care and support can be given to help those with poor health, as well as those recovering from long-term illnesses.

Looking at the connection between health and housing is a logical starting point, but how does it work in practice?

Part of my frontline role for a home improvement agency in the east of England is to promote the services we provide. We target GPs and hospitals, as our services could benefit their patients – specifically those who can not be discharged from hospital due to their housing conditions – but getting a foot in the door is often the biggest obstacle.

I have arranged meetings with surgery managers to discuss how we can work in partnership but arrive to find they are too busy to see me. However, when I chat with others about the services we provide, they can see how the work we docan prevent hospital admission. The housing sector needs to get to those involved in the decision making.

Perhaps the biggest barrier to overcome is funding. Last year, the Department of Health allocated an additional £20m for disabled facility grant funding, the finance mechanism for disability aids and adaptations. Typically, local authorities would have to pay for 40% of the grant but this has now changed and councils are no longer required to top up or match government funding.

Adaptations effectively pay for themselves while taking pressure off our already stretched health service. A report published last year by the London School of Economics highlighted an example of one London borough that had two wheelchair users in residential care due to the condition of their homes. Adapting the properties and making them fit for purpose saved £30,000 per client. Another local authority reported reductions in care costs of almost £2m over a five-year period as a direct result of investing £110,000 in 20 shower adaptations. These cost savings could be replicated by a consistent, collaborative working approach.

We do have a positive working relationship with Norwich city council and the Suffolk district councils who understand what we are trying to achieve. The councils recognise the link between housing and health and boast impressive turnaround times for their adaptations. The average wait in Norwich for an adaptation is between four and six months, compared to up to three years in some parts of the country. It is this forward thinking that we need to make a positive impact on what we and the health services provide.

Alan Sharman is casework team leader at Orbit Care and Repair

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