ScienceRise: Medical Science

Endoscopic forehead lift in combination with botulinum therapy and fillers: analysis of efficacy and safety

2025-12-16T10:59:31+02:00

The aim: Upper facial aging significantly impacts self-perception and quality of life as changes become apparent in the forehead, glabellar complex, and brow positioning. This narrative literature review evaluates clinical efficacy, safety profile and aesthetic outcomes of 3 treatment options: endoscopic forehead lift, botulinum toxin A and hyaluronic acid injectable dermal fillers, examining their individual and combined applications.

Materials and methods: Literature was obtained between April and August 2025 from electronic databases: PubMed, ScienceDirect, Google Scholar, Nature, Wiley Online Library, ResearchGate, Springer and Clinical key; using targeted search strategies. Inclusion criteria encompassed articles discussing these interventions in human participants published between 2000-2025. Exclusion criteria included mid-/lower face procedures, animal studies and non-peer reviewed editorials. Forty-one sources were selected based on clinical relevance and methodological quality.

Results: Endoscopic forehead lift demonstrated 93% patient satisfaction with superior long term structural repositioning. BoNT-A provided effective dynamic wrinkle reduction lasting 3-6 months with minimal complications. Hyaluronic acid fillers addressed volumetric deficits and static wrinkles lasting 6-18 months. Combined BoNT-A with HA fillers showed significantly enhanced outcomes, with 84.15% patient satisfaction at 6 months versus 55.12% with botulinum toxin A monotherapy. All modalities demonstrated excellent safety profiles with complications under 3%.

Conclusions: Multimodal rejuvenation addressing multiple aging mechanisms simultaneously results in superior aesthetic outcomes and patient satisfaction compared to single modality procedures. Substantial evidence gaps exist regarding optimal sequencing and long-term outcomes of combined surgical-injectable approaches. Future prospective studies examining endoscopic procedures with injectable modalities across diverse populations are essential to establish evidence-based clinical protocols

Evaluation of the results of the use of different types of autologous cartilage for restoration of structural support of the nose in secondary rhinoplasty

2025-12-26T12:01:16+02:00

According to the literature, from 14 to 50% of patients after primary rhinoplasty still require repeated interventions to correct aesthetic or functional defects of the nose, for which various types of autologous cartilage grafts are used. Despite the number of possible donor sites of autologous cartilage, their resorption still remains a significant problem in the context of the stability of long-term rhinoplasty results.

Objective: To conduct a comparative assessment of the clinical results of using different types of autologous cartilage in secondary rhinoplasty.

Materials and methods. A prospective study was conducted involving 54 patients aged 18 to 60 years who underwent secondary rhinoplasty in the period from January 2022 to January 2025 and who were divided into 3 groups according to the type of autologous cartilage. The study used questionnaires NOSE, ROE, VAS (satisfaction), photometry, and statistical research methods. Evaluations of the results were carried out at 3, 6, 12, 24, 36 months of follow-up.

Results. Three months after the intervention, the median NOSE score was 35 points. The ROE level 3 months after the operation was characterized by a median of 62.5 points. During the following months, a gradual increase in this score was observed until the twelfth month. Regarding objective indicators, the width of the nose one year after the operation was 32.4 mm, the height of the nasal bridge - 4.7 mm, the projection of the nasal tip was recorded at 21.3 mm. The height of the bridge showed a tendency to decrease (to 4.0 mm after three years).

Conclusions. The use of autologous cartilage grafts in secondary rhinoplasty provides a significant improvement in functional and aesthetic results without a statistically significant difference between the study groups. The process of cartilage resorption in all cases of rhinoplasty is progressive and correlates with the observation period. In our case, resorption was observed for the entire sample from 1.5% after one year to 2.3% after three years

eQTL-driven tissue-specific modulation by TMPRSS2 (rs12329760) and its potential role in COVID-19 susceptibility

2025-12-25T23:10:09+02:00

The aim of research – to analyze tissue-associated expression of the TMPRSS2 gene (rs12329760) using quantitative expression loci and assess its potential contribution to the formation of individual susceptibility to COVID-19.

Material and methods. Genotyping of TMPRSS2 (rs12329760) was performed for 48 patients with mild COVID-19 and 72 patients with moderate and severe disease. Peripheral blood leukocytes were used to isolate genomic DNA, and real-time polymerase chain reaction was used to genotyping gene polymorphisms. eQTL analysis was applied based on publicly available data from the QTLbase database to establish tissue-specific transcriptional effects of the TMPRSS2 variant (rs12329760).

Results. It was found that TMPRSS2 (rs12329760) showed the highest number of transcripts in prostate tissue. A total of 80 eQTLs associated with rs12329760 were identified, all of which were driven exclusively by cis-regulatory mechanisms, with these associations distributed across 19 tissues and involving regulatory interactions with 18 genes. The T allele of rs12329760 was associated with significantly increased expression of MX1, MX2, and AP001610.1 in CD4⁺ T lymphocytes, circulating monocytes, and B lymphocytes. In contrast, the C allele was associated with increased expression of FAM3B and BACE2 in CD16⁺ neutrophils and CD14⁺ monocytes. Opposing regulatory effects were also found: rs12329760 was associated with transcriptional suppression of C2CD2, PRDM15, TMPRSS3, and UMODL1 in CD4⁺ T cells and B lymphocytes, predominantly mediated by the T allele.

Conclusions. The TMPRSS2 gene (rs12329760) has broad tissue-specific regulatory activity, enhancing the expression of genes involved in the formation of the human antiviral response, while involving mechanisms related to the complement system and serine protease. These transcriptional effects suggest that rs12329760 may serve as a functional modifier of susceptibility and immune response in COVID-19

Organizational and statistical analysis of the human resources potential and qualification structure of the oncogynecological service in Ukraine

2025-12-26T17:29:04+02:00

The aim. To conduct an organisational and statistical assessment of the human resources potential and qualification structure of the gynaecological oncology service in Ukraine in the period 2015–2024, identifying key trends, regional imbalances and systemic risks.

Materials and methods. The research materials were the official reporting data of the Ministry of Health of Ukraine regarding the number of oncology doctors, their territorial distribution and qualification level by region of Ukraine. The work uses the methods of descriptive statistics, dynamic analysis, structural-dynamic analysis, inter-period comparison and elements of forecasting.

Results. During the analyzed period, an unstable change was observed in the total number of oncogynecologists, which was characterized by a decline in the crisis and an uneven subsequent recovery. Significant regional disparities in human resources have been identified, with the concentration of oncologists in large urbanized centers and acute shortages in many areas, especially in the front and rear areas. The conducted structural analysis revealed a gradual decrease in the share of specialists of the highest professional level with a simultaneous increase in specialists without qualification categories. A comparison of the prewar and wartime periods clearly revealed the increase in personnel losses, the migration of medical personnel, and a violation of structural stability.

Conclusions. The results of the study indicate the need to revise the personnel policy in oncology and gynecology, taking into account regional characteristics, stimulating the professional growth of doctors and introducing mechanisms for retaining highly qualified specialists in regions with a shortage of personnel. The obtained results have a practical application for making management decisions in planning medical resources, organizing the work of the network of specialized care and increasing the availability of oncological and gynecological care in Ukraine