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Objective: The current study aims to investigate the safety and efficacy of using calcium hydroxyapatite (CaHA) versus CaHA associated with hyaluronic acid (HA) for forehead volume replacement and contour restoration without forehead irregularities. Methods: This interventional study involved 132 participants in a two‐arm, parallel, double‐blind trial for forehead treatment using the supraperiosteal technique. Group A received CaHA, and Group B received a combination of CaHA and HA as filler materials. Follow‐up assessments occurred at 30 and 180 days, incorporating the 5‐point Global Aesthetic Improvement Scale (GAIS) and photographic analysis for forehead volume replacement, contour restoration, and without forehead irregularities. Safety assessments included monitoring adverse events, particularly nodules. Results: The study included all 132 enrolled patients who completed the trial. Applying CaHA in combination with HA resulted in a statistically significant improvement in both GAIS scale scores and the reduction of forehead irregularities. The total incidence of nodules was 3.7%. Group A had four times more occurrences of nodules than Group B. Furthermore, Group B exhibited lower rates of forehead irregularities following the treatment compared to Group A. Conclusion: The supraperiosteal application of CaHA and HA for forehead treatment demonstrates superior efficacy in addressing signs of aging compared to the isolated use of CaHA. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Objective Method Results Conclusion Dermal filler‐induced alopecia is a rare yet significant complication of aesthetic procedures primarily associated with vascular occlusion and subsequent tissue ischemia. Hyaluronic acid (HA) fillers, though widely used for facial rejuvenation, can lead to adverse outcomes such as skin necrosis and hair loss, particularly in high‐risk areas like the temples and glabella.This case report aims to highlight the clinical presentation, diagnostic approach, and multidisciplinary management of filler‐induced alopecia, contributing to the existing literature with a comprehensive review of previously reported cases.A 21‐year‐old female presented with localized skin necrosis and alopecia four days after receiving 7 mL of HA filler injections in the temples, tear trough, and eyebrow glabella regions. Trichoscopy revealed follicular dropout and white dots, consistent with ischemic hair loss. Treatment included hyaluronidase injections (1500 units), intralesional corticosteroids, topical minoxidil, and CO2 laser therapy. Over 1 year of follow‐up, the patient achieved complete hair regrowth and resolution of facial scarring.Only 16 cases of filler‐induced alopecia have been documented, predominantly involving HA fillers. This case underscores the importance of early recognition and intervention with hyaluronidase to mitigate ischemic damage. The multidisciplinary management approach employed here demonstrates the potential for full cosmetic recovery.Filler‐induced alopecia, though rare, necessitates heightened awareness among dermatologists and aesthetic practitioners. Adhering to recommended injection techniques and dosages, alongside the judicious use of ultrasound guidance, can minimize risks and improve patient safety. [ABSTRACT FROM AUTHOR]

Calcium hydroxyapatite (HAp) is a naturally occurring material in bones of humans and calcareous animals. In the biomedical field, HAp has been extensively used due to their high biocompatibility and non-toxicity. These properties of HAp coupled with high surface area and adsorption capacity have prompted its application in wastewater remediation. The most notable environmental application of HAp has been as an adsorbent and as base matrix for supporting photocatalysts. Interestingly, recent investigations have revealed the inherent photocatalytic properties of HAp, deeming it as a promising green photocatalytic material. Further, the photocatalytic behaviour of single-phase HAp can be accentuated by doping transition metals. A defect is created when metal dopant substitutes the Ca+2 ions in the HAp lattice, which makes the HAp/metal composite responsive to sustainable solar energy. This review stresses the different applications of HAps in wastewater remediation with impetus on the photocatalytic advanced oxidation process. In addition, a photocatalytic degradation pathway and a novel kinetic model of the HAp-based photocatalytic oxidation process have been proposed to understand the degradation mechanism and kinetics of pollutant removal. Furthermore, the recent investigations of HAp-based ceramic membranes have been elaborated in current work to demonstrate its remarkable hydrophilic and antibiofouling properties desirable in wastewater treatment with membrane filtration and photocatalytic membrane process. However, substantial improvements are required before upscaled HAp-based wastewater treatment technologies can be materialised. The future prospects for the upscaling and limitation of the HAp-based technology have been extensively discussed to lay the path for forthcoming investigations. [ABSTRACT FROM AUTHOR]

This article discusses the use of hyaluronic acid (HA) and calcium hydroxyapatite (CaHA) as injectables for the treatment of hypertrophic photoaging. The authors present a case study of a 56-year-old woman with prominent wrinkles and uneven skin texture. The patient was treated with a hybrid injectable containing HA and CaHA, and the results were evaluated using 2D and 3D photographs, as well as reflectance confocal microscopy (RCM). The treatment resulted in improved skin appearance, reduced wrinkles, and increased tissue support. The authors emphasize the importance of choosing the right product for each patient to achieve successful outcomes in facial rejuvenation. [Extracted from the article]

Background: Complications of temporary and permanent fillers have been extensively studied. However, there is a lack of comparative data regarding poly‐L‐lactic acid (PLLA), calcium hydroxyapatite (CaHA), and polycaprolactone (PCL) known as collagen biostimulators. Aims: This study addressed the complications of collagen biostimulators concerning their diagnosis, type of product, treatment, and monitoring. Patients/Methods: An electronic questionnaire was sent to Brazilian dermatologic ultrasound experts to identify complications related to biostimulators. The type of biostimulator, location of application, number of vials injected, application plan, time between injection treatment and complication, injector profile, treatment, and prognosis were assessed. Results: Fifty‐five cases were identified, of which 49.1% were caused by PLLA‐Elleva®, 23.6% by CaHA (alone or combined with hyaluronic acid), 20.0% by PLLA‐Sculptra®, and 7.3% by PCL. The most affected area was the face (72.7%), with nodules being the most common clinical form (89.1%), generally occurring late (60.0%) (>1 month). Only one case was injected at an incorrect depth (musculoaponeurotic system—SMAS). Despite several treatments, including saline (45.5%), hyaluronidase (25.5%), diluted corticosteroids (23.6%), and energy‐based devices (10.9%), only five cases showed complete resolution. Hyaluronidase was beneficial in complications related to fillers when there was an association of calcium hydroxyapatite with hyaluronic acid (p < 0.01). Conclusions: Complications from collagen biostimulators were more common on the face, typically manifesting about 1 month after treatment. These issues seemed to be related more to the properties of the products rather than inadequate technique. Furthermore, hyaluronidase demonstrated efficacy only in cases where there was an association with HA. [ABSTRACT FROM AUTHOR]

Background: The signs of aging seem to be more visible on the neck compared to other locations, especially if a patient has already gone through facial rejuvenation procedures. Treatment of the aging neck imposes a challenge to the clinician, since one single approach is usually not enough to achieve the desired result, requiring multiple injections and sessions, which apart from being painful for the patients, is time‐consuming for the clinician. Aim: To describe the use of calcium hydroxyapatite, incobotulinum toxin type A and Cohesive poly‐densified matrix hyaluronic acid diluted in the same syringe and injected in the same session for neck rejuvenation. Patients and Methods: Fifteen women, older than 18 years, with cervical skin flaccidity grade 1–4 in a previously validated 5‐point rating scale (Dermatologic Surg, 2016; 42, S94), who sought neck rejuvenation were injected in this pilot study with a single session with a combined hybrid mixture of calcium hydroxyapatite, incobotulinum toxin type A, and Cohesive poly‐densified matrix hyaluronic acid and followed up for 90–180 days. Results: At the 4‐month post injection evaluation, 93.3% of the patients presented at least 1‐grade improvement in the 5‐point scale as evaluated by the investigator. No serious adverse events were reported, being most mild and transient in nature. Conclusion: CaHA, incoBonTA, and CPM‐HA have complementary mechanisms of action and may be injected from the same syringe in the same session, boosting the final outcome, with high patient satisfaction, and ease of process for both patients and clinicians. [ABSTRACT FROM AUTHOR]

Abstract In glass industry, the evolved gases and fumes from burning the gas fuel absorbed in calcium hydroxide to minimize the pollution of environment. After a period of time, the calcium hydroxide fouled with sulphate and carbonate as action of the absorbed SO3 and CO2 gases. Based on our interest to treatment the solid waste materials, this study intended to convert the obtained waste of calcium hydroxide fouled with gases to valuable products. Firstly, this waste was treated with water, caustic soda and acids. The results confirmed the conversion of waste to pure calcium sulfate by treatment with 6 v/v% sulfuric acid. Secondly, the obtained calcium sulfate was reacted with ammonium dihydrogen phosphate solution for preparation of calcium hydroxyapatite (HAp) nanoparticles. The produced HAp sample was characterized by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), transmission electron microscopy (TEM) and scanning electron microscopy (SEM), thermal gravimetric analysis (TGA) and N2 adsorption measurements. The obtained findings confirmed that the HAp can be produced after calcination at 700 °C, nanorods-like of sizes ranged from 11 to 15 nm and with main surface functional groups of hydroxyapatite. TGA and DTA data indicated that HAp is thermally stable up to 700 °C. Also, the obtained HAp has Ca/P molar ratio of 1.60 and exhibited high total surface area of 146 m2/g with mesoporous structure which make this material can be used in medical and water purification applications.

In glass industry, the evolved gases and fumes from burning the gas fuel absorbed in calcium hydroxide to minimize the pollution of environment. After a period of time, the calcium hydroxide fouled with sulphate and carbonate as action of the absorbed SO3 and CO2 gases. Based on our interest to treatment the solid waste materials, this study intended to convert the obtained waste of calcium hydroxide fouled with gases to valuable products. Firstly, this waste was treated with water, caustic soda and acids. The results confirmed the conversion of waste to pure calcium sulfate by treatment with 6 v/v% sulfuric acid. Secondly, the obtained calcium sulfate was reacted with ammonium dihydrogen phosphate solution for preparation of calcium hydroxyapatite (HAp) nanoparticles. The produced HAp sample was characterized by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), transmission electron microscopy (TEM) and scanning electron microscopy (SEM), thermal gravimetric analysis (TGA) and N2 adsorption measurements. The obtained findings confirmed that the HAp can be produced after calcination at 700 °C, nanorods-like of sizes ranged from 11 to 15 nm and with main surface functional groups of hydroxyapatite. TGA and DTA data indicated that HAp is thermally stable up to 700 °C. Also, the obtained HAp has Ca/P molar ratio of 1.60 and exhibited high total surface area of 146 m2/g with mesoporous structure which make this material can be used in medical and water purification applications. [ABSTRACT FROM AUTHOR]

Background: Stress urinary incontinence (SUI) causes both physical and psychological problems to women and their partners. Recently, vaginal radiofrequency (RF) application, as well as the administration of non-crosslinked hyaluronic acid (NCLHA) together with calcium hydroxyapatite (CaHA), has attracted attention for SUI treatment. The current, comparative study evaluated the efficacy and safety of these technologies acting separately and in a combined treatment. Methods: Sixty women with mild to moderate SUI, aged between 46 and 76 years (mean age 63.2) were divided into three groups intended for different treatments: group I, RF vaginal treatment only, group II, NCLHA plus CaHA periurethral injection only, group III, combined treatment including a single periurethral injection of NCLHA plus CaHA followed by four vaginal applications of RF at intervals of 3–5 days. The clinical effects of the treatments were evaluated by ICIQ-LUTSqol (Polish version) and UDI-6. Results: The obtained results suggest that the symptoms of SUI and the quality of life of the patients improved significantly in each group after the therapies compared to the pre-treatment levels and were more persistent in the third HA + RF group compared to the HA or the RF group. [ABSTRACT FROM AUTHOR]

The advancement of bioimaging and theranostics necessitates the development of highly biocompatible multifunctional agents. Here, we introduce a potential multimodal agent based on nanosized hydroxyapatite (HAp) co-doped with europium(III) and gadolinium(III) (Eu3+ and Gd3+) ions. The study presents a detailed characterization of the HAp:Eu3+/Gd3+ nanoparticles synthesized via the co-precipitation method. The structure and morphology were analyzed using X-ray powder diffraction (XRPD), transmission electron microscopy (TEM), and Fourier transform infrared (FT-IR) spectroscopy. The study of spectroscopic properties (emission, excitation, emission kinetics) as a function of optically active ions was carried out. Moreover, various dopant ratio combinations were studied to optimize the optical and magnetic properties. HAp:Eu3+/Gd3+ demonstrates tunable PL intensity with different concentrations of Eu3+ and Gd3+ ions and increased magnetization with higher doping with Gd3+ ions. Furthermore, co-doping with Gd3+ ions results in an enhancement of Eu3+ emission intensity, rendering HAp:Eu3+/Gd3+ a potentially promising candidate for bioimaging applications. [ABSTRACT FROM AUTHOR]

In this study, the phosphogypsum waste taken from various places in the factory dump located in Kėdainiai (Lithuania) was reinspected and characterised by different physico-chemical characterisation methods. The results of X-ray diffraction analysis, thermogravimetric analysis and differential scanning calorimetry, Fourier transform infrared spectroscopy, energy-dispersive X-ray analysis, elemental analysis using inductively coupled plasma optical emission and X-ray fluorescence spectroscopy confirmed that the main crystalline phase of the phosphogypsum waste is gypsum (CaSO4·2H2O). The surface morphology of the investigated materials was analysed using scanning electron microscopy. The specific surface area was determined by the Brunauer-Emmet-Teller method. The pore size distribution of the material produced was obtained using the Barrett-Joyner-Halenda method. This study also demonstrated that the phosphogypsum waste could be successfully used as a precursor for the dissolution-precipitation synthesis of high quality bioceramic calcium hydroxyapatite. [ABSTRACT FROM AUTHOR]

Hydroxyapatite crystal deposition disease (HADD) poses diagnostic challenges in the emergency department (ED) as it may clinically present similarly to infection and other musculoskeletal conditions. Misdiagnosis often leads to unnecessary treatments and resource over-utilization. This review article provides an overview of HADD in seven patients who presented to the ED secondary to an acute presentation of this disease process. HADD is a prevalent pathology, which commonly involves the shoulder, followed by the hip, elbow, wrist, and knee. Predisposing risk factors, such as diabetes and certain genetic factors, have also been identified. Clinical history and imaging, particularly radiographs, play a vital role in diagnosing HADD, with characteristic calcification patterns observed in different stages of the disease. Conservative nonsurgical therapy is the mainstay of treatment, providing effective symptom relief in over 90% of cases. By recognizing HADD as a crucial differential diagnosis for patients with acute or chronic pain, healthcare resource utilization can be optimized, leading to improved patient care in the ED. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to evaluate and compare the efficacy and safety of treating atrophied labia majora with hyaluronic acid (HA) and calcium hydroxyapatite (CaHA). Methods: Ten participants complaining of sagging or loss of volume in the labia majora were evaluated and randomly assigned to two groups—treated with CaHA or AH. Photographic documentation was taken and appreciated by the participants and by blind observers. Results: The study showed an improvement in labia majora regarding volumization and flaccidity that was more significant after 90 days of treatment in both treatments. Besides flaccidity, volume replacement resulted in better balance and proportion between the labia majora and labia minora. The evaluators, independent and blind, judged that in 80% of the cases of the HA group and in 50% of cases of the CaHA group, there was an excellent improvement. Conclusion: CaHA and HA are both effective and safe for treating the intimate region, and this study cannot prove the superiority of one over the other. An appropriate assessment involving the analysis of sagging and/or volume loss and the creation of a sequential treatment protocol, involving CaHA and HA, seems to be the best solution. Level of Evidence I: Evidence obtained from at least one properly designed randomized controlled trial. 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. [ABSTRACT FROM AUTHOR]

Seafood products have contributed significantly to the world's source of dietary protein and various nutrients. Developing an innovative seafood product (ISP) such as calcium hydroxyapatite (HAp) provides a high-nutrient ingredient for foods and seafood. Despite the potential of this ISP as an ingredient, the conventional processing approach requires multiple steps, high energy, and raw materials usage to produce mediocre products. This study aims to evaluate the efficacy of ultrasound in facilitating the HAp extraction process. Samples were separated into ultrasonication (low-intensity= 0.18 W/cm², moderate-intensity 0.35 W/cm², and high-intensity= 0.41 W/cm² at 37 kHz for 15 mins) and without ultrasonic treatments, with the same technique. The efficacy of the extraction process was analyzed in terms of the yield percentage, whiteness index (WI), morphological characteristics, particle size distribution, elemental composition, crystallinity phase, degree of crystallinity, and crystallite size. The low-intensity and moderate-intensity ultrasonication significantly reduces the WI and yield of HAp obtained. The high-intensity ultrasonication did not significantly affect yield, WI, and growth orientation. However, it reduces particle size from 200 to 550 nm to 26-42 ran, and narrowing the distribution range. Crystallinity is also significantly improved by ultrasonic energy, from 61% to 79%, with a slightly larger crystal size (24 nm) than without ultrasound. Findings on a novel cost-effective approach and ultrasonic effect seem relevant for other extraction systems of different biomaterials. [ABSTRACT FROM AUTHOR]

Pressure-induced alopecias (PAs) are an infrequent group of scarring and nonscarring alopecias that occur after ischemic obstruction of capillaries that leads to circumscribed areas of hair loss. Initially described after prolonged surgeries or immobilization, type 1 PA occurs after sustained external pressure to the skin, mainly the scalp prominences. Alopecia induced by cosmetic procedures, referred in this review as type 2 PA, is reported with increased frequency in literature and predominantly emerges from pressure exerted by the volume of injectables. It is important to differentiate type 2 PA from vascular occlusion-induced alopecia because they represent distinct entities. Clinically, PA may present with erythema, swelling, and tenderness; however, alopecia might be the sole manifestation. Crusts and ulceration are associated with a worse outcome and a higher risk of scarring alopecia. Prompt diagnosis is paramount to prevent complications. Trichoscopy, although considered nonspecific, may provide relevant clues for an accurate diagnosis. Hair regrows in most cases, but prognosis depends on ischemia severity and timely treatment with reperfusion therapies or mobilization. Treatment of hair loss is usually not necessary because the disease in most cases is self-limited and reversible. The role of topical minoxidil and corticosteroids remains unknown. [ABSTRACT FROM AUTHOR]

Background: After significant weight loss, the abdominal skin can become permanently stretched, resulting in stretch marks, laxity, and thinning of the dermis. For many patients, surgical methods such as abdominoplasty are too risky due to the potential for complications, the lengthy recovery period, and the high cost. Objective: The purpose of this pilot study was to use microfocused ultrasound, calcium hydroxyapatite, and Incobotulinum toxin A to improve the appearance of patients who were suffering from abdominal skin laxity after heavy weight loss. The combination of these treatments can provide comprehensive results with minimal downtime and lower risk compared to traditional surgical procedures. Methods: Our team treated four female Chinese patients with microfocused ultrasound, diluted calcium hydroxylapatite, and Incobotulinum toxin A with different combinations, respectively. The first and second cases were only treated with 810 shots of microfocused ultrasound. The third case received 850 shots of microfocused ultrasound plus 5 mL of diluted calcium hydroxylapatite and 50 units of Incobotulinum toxin A on the left abdominal skin, and the fourth case was treated with 900 shots of microfocused ultrasound plus 5 mL of diluted calcium hydroxylapatite and 10 units of Incobotulinum toxin A on the left abdominal skin. All four patients received a single treatment session. Clinical photographs were taken before each treatment, and two individual blinded investigators were asked to assess photographs taken after 4 weeks and compare them with the pretreatment photos. Results: All four cases showed an overall clinical improvement, with the third and fourth cases demonstrating more significant skin tightening based on photographic analysis. The data indicate that the inclusion of calcium hydroxylapatite and Incobotulinum toxin A in microfocused ultrasound treatment yields superior results for abdominal rejuvenation. Conclusions: Abdominal skin laxity can be treated with a triple therapy combining microfocused ultrasound, diluted calcium hydroxylapatite, and Incobotulinum toxin A. [ABSTRACT FROM AUTHOR]

Case report: we report the case of a 48-year-old woman with pain in the maxillary sinuses and temporal areas. The presence of subcutaneous facial calcific plaques was confirmed in computed tomography (CT). Both the physical examination and the lab test results were within normal limits. Upon further questioning, the patient mentioned that she had been administered a facial filler product containing calcium hydroxyapatite (CaHA) (Radiesse®) the year before. Discussion: CaHA microspheres are radiopaque, making them visible through conventional x-rays, especially CT scans. The characteristic imaging features, typically bilateral and separate from the bone, along with the history of previous injection of this material, should help the clinician recognize this finding and isolate it from other conditions and diseases. Because of the popularity of this facial rejuvenation technique, clinicians should be familiar with the imaging characteristics associated with the deposition of this substance. [ABSTRACT FROM AUTHOR]

Background: Stress urinary incontinence (SUI) causes both physical and psychological problems to women and their partners. Recently, vaginal radiofrequency (RF) application, as well as the administration of non-crosslinked hyaluronic acid (NCLHA) together with calcium hydroxyapatite (CaHA), has attracted attention for SUI treatment. The current, comparative study evaluated the efficacy and safety of these technologies acting separately and in a combined treatment. Methods: Sixty women with mild to moderate SUI, aged between 46 and 76 years (mean age 63.2) were divided into three groups intended for different treatments: group I, RF vaginal treatment only, group II, NCLHA plus CaHA periurethral injection only, group III, combined treatment including a single periurethral injection of NCLHA plus CaHA followed by four vaginal applications of RF at intervals of 3–5 days. The clinical effects of the treatments were evaluated by ICIQ-LUTSqol (Polish version) and UDI-6. Results: The obtained results suggest that the symptoms of SUI and the quality of life of the patients improved significantly in each group after the therapies compared to the pre-treatment levels and were more persistent in the third HA + RF group compared to the HA or the RF group.

INTRODUCTION: For religious reasons, a portion of the population does not expose their body, showing only the feet. OBJECTIVE: This study aimed to meet the demand for treatments to rejuvenate the dorsum of the foot, observe the safety of using calcium hydroxyapatite and its results, and discuss the region anatomy. METHODS: Sixty women with an average age of 63 years and skin phototypes from I to VI had the dorsum of their foot's age classified by types from I to VII, and were injected with 0.75 ml to 3 ml of calcium hydroxyapatite per patient in this region, in a single session. A dermatologist who did not participate in the treatment and the patients conducted the evaluation through photos. RESULTS: The results were considered good to very good depending on the aging stage of the dorsum of the feet. Complications were limited to local edema and erythema. Follow-up lasted from six months to one year. CONCLUSION: The injection of calcium hydroxyapatite into the dorsum of the feet, based on knowledge of the anatomy of this region and correct volume, could be considered a body area treatment.

Objective: Facial aging is a complex process that involves genetic, biological, and environmental factors. This paper aimed to present the first aesthetic and safety outcomes of a hybrid filler that combines hyaluronic acid (HA) (20 mg/mL) and calcium hydroxyapatite (HA/CaHa). Methods: Prospective and non‐randomized interventional study conducted on consecutive healthy patients who attended the clinic for an aesthetic facial rejuvenation procedure. HA/CaHa was injected with 23G cannula (retrograde threads, 1.25 mL per side) in the preauricular region. Ultrasound examinations, elastography images, and 2D and 3D photographs were performed before and after treatment. The primary endpoint were the volumetric changes at Day 180. Results: Fifteen patients were included in the study. At Day 180 after treatment, median (interquartile‐range) volume increased by 2.1 (1.9–2.3) cc and 2.1 (1.8–2.2) cc in the right‐ and left‐side, respectively, p < 0.0001 each. As compared to pretreatment values, facial‐tension vectors significantly increased by 2.2 (1.6–2.2) mm and 2.0 (1.7–2.2) mm in the right and left side, respectively, p < 0.0001 each. Elastography images demonstrated an increase in collagen fibers at post‐treatment Day 60, which was confirmed on Day 90, and reached the peak effect between Days 90 and 180. Regarding safety, there were no either unexpected or serious treatment‐related adverse events. Most patients experienced a mild redness and inflammation that resolved within the first 48 h without treatment. Conclusions: The HA/CaHa hybrid filler (HArmonyCa™), besides its volumizing and lifting properties, was associated with an increase in the viscoelasticity, both at the level of the reticular dermis and the subcutaneous cellular tissue, which might be indicative of the formation of new collagen fibers. [ABSTRACT FROM AUTHOR]

Recently, thanks to the greater discovery of the mechanisms of facial aging, an alternative to invasive plastic surgery has found space with less invasive aesthetic procedures, also based on an increasingly pressing request. We are specifically referring to dermal filler injection into or under the skin which leads to immediate rejuvenation and aesthetic improvements. In this study, we wanted to analyze the results obtained through the use of NEAUVIA Organic Stimulate, particularly with regard to its effectiveness, which is a cross-linked polymeric hydrogel, containing stabilized sodium hyaluronate 26 mg/mL and calcium hydroxyapatite (1%), glycine and L-proline in buffer pyrogen-free water, in its main indication, namely, the temporary correction of congenital and acquired deficiencies of the soft tissues of the face by intradermal injection. Initially, 70 patients were enrolled, but 10 did not complete the study due to non-observance of the investigation rules, so they were excluded from the protocol. The collected data demonstrate an efficient mechanical effect of the pegylated polymeric acid matrix enriched with low concertation of calcium hydroxyapatite and in accordance with other evidence in vitro and in vivo, and the mechanical support of the interstitial connective space improves the homestays of the anatomical layer rebalancing the physiological activity of the dermis cells. [ABSTRACT FROM AUTHOR]

Abstract Background Vocal-fold augmentation is a continuously developing treatment modality for glottic insufficiency. Patients with glottic insufficiency attend the phoniatrics clinics with increasing frequency. Glottic insufficiency may be due to vocal-fold paralysis, paresis, atrophy, sulcus vocalis, scarring, and vocal-fold deficiency after laryngeal surgery. A variety of materials exist for injection augmentation. This follow-up study aimed to assess the short-term as well as long-term outcomes of vocal-fold injection with calcium hydroxyapatite (CaHA) in patients with glottic gap 1–3 mm. Method This study included 25 patients with glottic insufficiency who underwent injection augmentation with CaHA. All patients were scheduled for voice evaluation using a comprehensive subjective and objective battery of assessments. Assessments were performed before the procedure and after the procedure at 2 months and at 1 year. Results Perceptual voice quality assessed with the GRBAS scale improved and the results were stable after 1 year. Shimmer and HNR improved continuously through the follow-up sessions, while jitter and f0 showed slight improvement after CaHA injection. Conclusion Voice improvement after injection of CaHA requires a minimum of 2 months to develop and may last for a long period.

Background. The healing of skin wounds having various etiologies is known to involve a multistep process characterized by certain intercellular interactions affecting dermal cells, their attachment, migration, and differentiation. Here, recovery is interpreted as the return of dermis to its original state. The fact is, however, that the dermal extracellular matrix (ECM) is structurally impaired, which suppresses the regulatory and repository functions of the dermis, leading to the formation of a scar that inhibits several biological functions in the affected area and causes aesthetic problems associated with mobility.Objectives. To evaluate the structural features of dermis during wound healing using a calcium-containing biodegradable implant.Methods. The study used 60 rats that were inflicted with a third-degree burn injury (partially damaged dermis). The selected animals were divided into two groups: experimental and control. On post-burn day 14, a calcium-containing biodegradable implant was administered to rats from the experimental group, while a sterile saline solution was used in the control group. Material was sampled at two months (74 days) and four months (134 days). In order to assess the morphological state of the burn area, its sections were stained with hematoxylin and eosin, according to Mallory and Van-Gieson. For the selective detection of collagens, immunohistochemical tests using antibodies to collagen types I and III (Abcam, England) were employed. To characterize dermal cells, the authors used antibodies to vimentin (LabVision, USA), as well as to СD-68 (cluster of differentiation 68), α-SMA (alpha-smooth muscle actin), CD-105 (cluster of differentiation 105), and VEGF (vascular endothelial growth factor) receptors (Abcam, England). The obtained results were processed using the Statistica 6 software (StatSoft, USA).Results. The administration of a calcium-containing biodegradable filler during the burn healing process was found to ensure local fibroblast activation with the formation of collagen types I and III. When the implant residence time was prolonged up to four months, an increase in the number of macrophages expressing CD-68 receptors was observed. Of note is that these cells retained their localization, while α-SMA-expressing cells were localized in both the superficial and deep dermal compartments. The number of cells expressing CD-105 and VEGF rose as well.Conclusion. The use of the biodegradable filler is found to be promising in terms of post-burn dermal regeneration, as well as providing a dermal ECM, whose collagen network composition and assembly are similar to the original. Here, macrophages act as the primary synthesis regulators of the dermal ECM and stimulate fibroblasts, which ensures re-epithelialization and angiogenesis of the inflicted area.

Background: An increasing demand for in‐office aesthetic procedures aiming to improve collagen stimulation has been reported. Objective: To analyze the effects of combinations of different aesthetic collagen stimulation procedures using histological analysis. Methods: Histological analysis was performed on skin samples of the excess skin of a 60‐year‐old patient after sub‐superficial musculo‐aponeurotic system facelift surgery. The excess skin before facelift surgery was divided into three areas per hemiface. Each area—with exception of area A as a control—received an isolated or combined treatment of microfocused ultrasound (MFU), injections of calcium‐hydroxylapatite/hyaluronic‐acid‐based soft tissue filler, and microneedling. The effect of the treatments was analyzed using histological analysis with H&E coloration and PAS staining. Results: A threefold increase of epidermal and dermal thickness was achieved by treating the skin with the proposed combined treatment comprising MFU and injections of calcium‐hydroxylapatite‐ and hyaluronic‐acid‐based soft tissue fillers. Conclusion: The investigated treatments act synergistically in the production of collagen and combining these treatments allows for an increase in collagen production. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this report is to evaluate the efficacy of endoscopic injection of calcium hydroxyapatite (CaHA) into the bladder neck and posterior urethra in children with refractory urinary incontinence due to spinal dysraphism. Methods: A retrospective study was performed on patients with neuropathic bladder due to spinal dysraphism who had undergone submucosal urethral injections of CaHA from 2010 until 2019. All patients were totally incontinent without voiding per urethra and did not respond to 1-year standard pharmacotherapy with anticholinergic drugs. All children underwent a precise physical exam and urodynamic studies. Patients underwent urethrocystoscopy and injection of pure soluble CaHA into the bladder neck and posterior urethra except for the verumontanum. The outcomes were determined as no change, improvement (social continent), or cure (total continent). Results: Fifteen children (ten boys, five girls, mean age of 7.6 years) with a history of spinal dysraphism and refractory urinary incontinence were included. Endoscopic injections of CaHA were performed one or two times for each patient. At the median follow-up of 2 years (interquartile range = 6), seven (46.7%), three (20.0%), and five (33.3%) of the patients were total continent, social continent, and total incontinent, respectively. In four patients, intradetrusor botulinum toxin injection was performed simultaneously with CaHA injection. Also, one patient experienced a febrile urinary tract infection between two CaHA injections. Among 15 patients, 9 had atonic/hypotonic bladders both before and after CaHA injections; at the last follow-up, 4 of these children (44.4%) were totally continent. No injection-related or other complications were observed in the patients. Conclusion: Injection of CaHA into the bladder neck is relatively safe, reproducible, and effective for total dribbling urinary incontinence in children with spinal dysraphism. The bladder neck reconstruction with or without a urethral sling or other surgical procedures could be postponed until puberty in selected cases. However, further multicenter clinical trials are highly recommended. [ABSTRACT FROM AUTHOR]

Bianca Viscomi Dermatology, Private Practice, São Paulo, São Paulo, BrazilCorrespondence: Bianca Viscomi, Dermatology, Private Practice, R Correia Dias, 530 suite 131, São Paulo, São Paulo, ZIP 04104-001, Brazil, Tel +55 11 97222-0525 ; +55 113051-2304, Email biancaviscomi@yahoo.com.brAbstract: A transgender individual is someone who does not identify with his or her biological sex1. During the transgender transition process, minimally invasive procedures (MIP) provide a versatile tool in the clinician’s therapeutic armamentarium, since the changes can be impactful for the patient, yet reversible, especially for the patient who is unsure about proceeding with a definite surgery. We report 5 cases of facial feminization of transgender women, illustrating the use of minimally invasive facial remodeling procedures for male-to-female transitioning patients.Keywords: transgender, feminization, botulinum toxin, hyaluronic acid fillers, calcium hydroxyapatite, skin quality

About 80% of wastewater is discarded into the environment without any treatment. In this research work, the metal hydroxyapatite nanoparticles had been synthesized by a wet chemical approach and applied in water treatment applications by using them as adsorbents for the removal of Red 3R dye from an aqueous solution. The obtained products had been characterized by FTIR spectroscopic technique to confirm the synthesis of respective products by ensuring the presence of phosphate and hydroxyl functional groups. Batch experiments were performed and all effective parameters were optimized and their optimized values were 21 mg/g achieved at pH 7.0, adsorbent dose 0.05 g, initial dye concentration 75 mg/L, and contact time 75 min using metal hydroxyapatite nanoparticles. Moreover, the effect of surfactants and electrolytes was also studied. The Red 3R dye adsorption process was explained by the Langmuir isotherm this type of behavior showed the formation of a monolayer of dye molecules on the adsorbent surface and pseudo-second-order kinetic model. The thermodynamic parameters indicated that Red 3R dye adsorption was exothermic and spontaneous. Given the promising adsorption efficiency of metal hydroxyapatite nanoparticles, they might be used as an alternative class of adsorbents for the adsorption of dyes from industrial effluents. [ABSTRACT FROM AUTHOR]

In this study, the effects of sodium lauryl sulfate and various amino acids (DL-aspartic acid, dodecanedioic acid, and suberic acid) on the formation of calcium-deficient hydroxyapatite via hydrolysis of α-tricalcium phosphate (α-TCP) were investigated; moreover, a combined effect of these additives and ethylene glycol as a synthesis medium was also estimated. The hydrolysis reaction was performed in solutions containing different concentrations of additives in aqueous and mixed aqueous–organic media under solvothermal conditions. It was demonstrated that the nature and the concentration of organic additives influence the phase purity and morphology of the final product. Higher concentrations of sodium lauryl sulfate and dodecanedioic acid induced the formation of impurities in addition to hydroxyapatite, while aspartic and suberic acid did not affect the phase purity. The morphology of the samples varied from plate- to rod-like depending on the concentrations of specific organic additive. [ABSTRACT FROM AUTHOR]

In this study, a low-temperature synthetic approach was developed for the fabrication of calcium hydroxyapatite (CHAp) coatings on a titanium substrate. The titanium substrates were first coated with CaCO3 by a spin-coating technique using a sol–gel chemistry approach, and the obtained product was transformed into CHAp during a dissolution–precipitation reaction. The phase purity and structural and morphological features of the obtained CHAp coatings were evaluated by X-ray diffraction (XRD) analysis, FTIR spectroscopy, Raman spectroscopy, scanning electron microscopy (SEM) and using a 3D optical profilometer. It was demonstrated that almost-single-phase CHAp formed on the titanium substrate with a negligible number of side phases, such as Na2HPO4 (starting material) and TiO2. In the Raman spectrum of the CHAp coating, the peaks of phosphate group vibrations were clearly seen. Thus, the obtained results of Raman spectroscopy correlated well with the results of X-ray diffraction analysis. The corrosive behaviour of CHAp coatings on a titanium substrate was also evaluated using electrochemical methods. It was found that the corrosion resistance of titanium coated with CHAp increased significantly. These CHAp thin films may be potential candidates for use in not only in regenerative medicine but also in the development of different sensors. [ABSTRACT FROM AUTHOR]

Background: After significant weight loss, the abdominal skin can become permanently stretched, resulting in stretch marks, laxity, and thinning of the dermis. For many patients, surgical methods such as abdominoplasty are too risky due to the potential for complications, the lengthy recovery period, and the high cost. Objective: The purpose of this pilot study was to use microfocused ultrasound, calcium hydroxyapatite, and Incobotulinum toxin A to improve the appearance of patients who were suffering from abdominal skin laxity after heavy weight loss. The combination of these treatments can provide comprehensive results with minimal downtime and lower risk compared to traditional surgical procedures. Methods: Our team treated four female Chinese patients with microfocused ultrasound, diluted calcium hydroxylapatite, and Incobotulinum toxin A with different combinations, respectively. The first and second cases were only treated with 810 shots of microfocused ultrasound. The third case received 850 shots of microfocused ultrasound plus 5 mL of diluted calcium hydroxylapatite and 50 units of Incobotulinum toxin A on the left abdominal skin, and the fourth case was treated with 900 shots of microfocused ultrasound plus 5 mL of diluted calcium hydroxylapatite and 10 units of Incobotulinum toxin A on the left abdominal skin. All four patients received a single treatment session. Clinical photographs were taken before each treatment, and two individual blinded investigators were asked to assess photographs taken after 4 weeks and compare them with the pretreatment photos. Results: All four cases showed an overall clinical improvement, with the third and fourth cases demonstrating more significant skin tightening based on photographic analysis. The data indicate that the inclusion of calcium hydroxylapatite and Incobotulinum toxin A in microfocused ultrasound treatment yields superior results for abdominal rejuvenation. Conclusions: Abdominal skin laxity can be treated with a triple therapy combining microfocused ultrasound, diluted calcium hydroxylapatite, and Incobotulinum toxin A.

ObjectiveCalcium hydroxyapatite (CaHA) is a common material for vocal fold injection augmentation. Durability is variable, and factors involved in implant longevity are not understood. Animal models of osteoporosis show decreased bone density and increased mineral liberation, suggesting CaHA retention may be altered in these conditions.Study designProspective murine investigation.MethodsFourteen skeletally mature, 10-month-old female Sprague-Dewley rats were treated by one of three interventions: oophorectomy, laparotomy without oophorectomy (sham), or monthly risedronate injection (90 μg/kg, subcutaneous). CaHA was implanted into the right lateral thigh muscle in all animals at the time of procedure or first risedronate injection. After 17 weeks, all rats were sacrificed, and the residual CaHA isolated from excised lateral thigh muscle through incubation in a 900 °C calcinator for 9 hours.ResultsMean CaHA mass remaining in the oophorectomy group was 65.9 (standard deviation ± 16.1) mg, compared to 44.4 ± 10.0 mg CaHA in the risedronate group and 48.6 ± 7.5 mg in the sham group. One-way analysis of variance found a statistically significant difference between the oophorectomy and risedronate groups but not between the sham and other groups, F(2,11) = 4.404, P = 0.039.ConclusionPersistent estrogen deficiency in a murine model of osteoporosis demonstrated decreased rate of CaHA resorption. This suggests that hormone alterations associated with osteoporosis may alter the longevity of CaHA implant resorption through an uncertain mechanism.Level of evidenceNA. Laryngoscope, 2576-2580, 2018.

We report a simple process for the preparation of crystalline calcium hydroxyapatite powder with increased fluidity, suitable for plasma spraying and 3D printing of ceramic bioresorbable implants. Particles less than 15 μm in size have been shown to influence the fluidity of hydroxyapatite powder. We demonstrate that, using a technique that includes grinding, annealing, and removal of small particles by wet–dry sieving, one can obtain powder having a fluidity of 57.1 s/50 g and ranging in particle size from 40 to 90 μm. [ABSTRACT FROM AUTHOR]

Background: Although much has been published on the use of poly‐L‐lactic acid (PLLA) and calcium hydroxyapatite (CaHA) for off‐face indications, questions remain regarding their exact mechanisms of action in subcutaneous tissue and their comparative efficacy. Objective: To present the clinical and histological results of the PLLA and CaHA injections into the opposing arms of the same patients. Methods: Five women received superficial subcutaneous injections of PLLA into the left arm and CaHA into the right arm. After three sessions, the clinical and histological outcomes were analyzed. Results: After the first session, three patients showed improvement in the right arm (CaHA), but at the end of study, two patients showed better results in the left arm (PLLA). Histologically, moderate to intense lymphocytic and giant cell infiltrate, as well as collagen and elastic fiber neoformation, were observed equally near the particles of both products. Dermis had no inflammatory or fiber alterations. Conclusion: In this study, there were no clinical differences between these two fillers. Despite current thinking and previous histological studies, we found both products produced moderate to intense inflammatory reaction, as well as collagenic/elastogenic fiber neoformation, only in the subcutaneous tissue of the immediate vicinity and surrounding the individual filler particles. [ABSTRACT FROM AUTHOR]

Despite the development of the dental industry, the prevalence of dental hypersensitivity does not decrease but increases at a progressive rate. Given the above, the subject of our research was the development of dental medicinal films with micronized calcium hydroxyapatite under the trade name «Kalident Powder 100» (Kalichem, Italy) for the treatment of dental hyperesthesia and caries prevention. To establish the optimal method of calcium hydroxyapatite introduction into the dental film, it was necessary to study the influence of different dispersion mediums on the physicochemical characteristics of the substance under study. Purified water, ethyl alcohol 96%, polysorbate 80, glycerol, polyethylene oxide-400, propylene glycol, sunflower oil, vaseline oil were used as dispersion medium in the studies. Research of physico-chemical characteristics was performed both for the substance «Kalident Powder 100» separately and for its mixtures with the studied liquids and their combinations (in a ratio of 1:1). The following physico-chemical characteristics have been determined: disperse and diffraction analysis of particle size distribution, morphological description, linear dimensions, shape factor, volume coefficient, Martin and Ferret diameters, wettability. The results of crystallographic and disperse analysis have revealed the polydispersity of the substance «Kalident Powder 100» and its high ability to agglomerate, which may adversely affect the homogeneity of its distribution in the dental medicinal product. A study of the effect of different dispersion medium on the physicochemical characteristics of calcium hydroxyapatite has shown a positive effect of hydrophilic liquids on the wettability of powder particles, changes in their shape, size, and distribution in the studied samples. It has been established that the combination of the substance «Kalident Powder 100» with combined solvent systems containing purified water, polysorbate 80, glycerol, and PEO-400, allows achieving optimal shape and particle size of calcium hydroxyapatite with their uniform distribution throughout the liquid, which is also confirmed by the results of laser diffraction. The obtained results will be used in further research on the development of dental medicinal film.

Background. A leading concept in modern regenerative medicine is the perspective of using own body resources to remodel organs and tissues via the formation of “living scaffold”. A pivotal role in the formation of dermal scaffold is played by fibroblasts that produce extracellular matrix (ECM).Aim. A study of the fibroblast activation mechanism mediating synthesis of the dermal ECM fibrillar component under the Facetem filler administration.Methods. The experimental trial was conducted in Wistar male rats (72 animals). Animals had 0.05 mL Facetem (Korea) injections subdermally. The filler is a calcium-containing product featuring gradual degradation delivered through structural microspheric properties of the Lattice-pore technology. Biological material was sampled at weeks 1 and 2 of months 1, 2, 3 and 5. Tissues were paraffin-embedded in standard histological assays and stained with Mallory’s trichrome, Picrosirius red in polarisation microscopy and immunohistochemistry with collagen types I, III and elastin antibodies (Abcam).Results. Collagen distribution in dermis and the filling zone suggests that collagen production occurs by week 2 of the Facetem filler placement followed by an increase in synthesised matrix volume to 4.39 ± 0.7 for collagen type I and 3.9 ± 0.2 for collagen type III (p < 0.05). The synthetic activity of fi broblasts reduces by month 3, albeit with collagen production remaining above control even by the end of month 5. Elastin synthesis also initiates by week 2 of the filler injection in dermis and grows by month 3.Conclusion. The presence of Facetem filler triggers a foreign body inflammatory response in dermis. This multifactorial process initiates with protein adsorption proceeding to dermal cell recruitment and modulation of fibroblasts and macrophages. Activation of these cell types induces neocollagenesis entailing the extracellular matrix synthesis and expansion in dermis.

With the use of light-curing Bis-GMA (Bis-phenol-А glycidylmethacrylate) adhesive and nanocrystalline carbonatesubstituted calcium hydroxyapatite (nano-сHAp), corresponding by an aggregate set of characteristics to the apatite of human enamel and dentin obtained from the biogenic source of calcium – egg’s shell of birds biomimetic Bis-GMA/nano-сHAp adhesives were synthesized. Introduction and distribution of nano-cHAp filler in the adhesive matrix as well as its interaction with molecular groups of the latter one resulted in the change of chemical bonds that was evidenced by the data of Fourier transform infrared (FTIR) spectroscopy. In summary, for the specified nanofiller concentration increased values of Vicker hardnesses (VH) and degree of conversion were attained simultaneously while light curing of Bis-GMA/nano-cHAp adhesive. This result would provide a considerable influence on the following application of the developed biomimetic adhesives and clinical successes of teeth restoration with the use of these composites

Recently, thanks to the greater discovery of the mechanisms of facial aging, an alternative to invasive plastic surgery has found space with less invasive aesthetic procedures, also based on an increasingly pressing request. We are specifically referring to dermal filler injection into or under the skin which leads to immediate rejuvenation and aesthetic improvements. In this study, we wanted to analyze the results obtained through the use of NEAUVIA Organic Stimulate, particularly with regard to its effectiveness, which is a cross-linked polymeric hydrogel, containing stabilized sodium hyaluronate 26 mg/mL and calcium hydroxyapatite (1%), glycine and L-proline in buffer pyrogen-free water, in its main indication, namely, the temporary correction of congenital and acquired deficiencies of the soft tissues of the face by intradermal injection. Initially, 70 patients were enrolled, but 10 did not complete the study due to non-observance of the investigation rules, so they were excluded from the protocol. The collected data demonstrate an efficient mechanical effect of the pegylated polymeric acid matrix enriched with low concertation of calcium hydroxyapatite and in accordance with other evidence in vitro and in vivo, and the mechanical support of the interstitial connective space improves the homestays of the anatomical layer rebalancing the physiological activity of the dermis cells.

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