Tag: 13/6/25

Categories : Expert Opinion Surgeries & ProceduresTags : Leave a comment

Surprising Shifts in Who’s Getting What in South African Cosmetic Surgery

On By ModernMedia
Professor Chrysis Sofianos

Twenty years ago, cosmetic surgery was still a subject of taboo, whispered about behind closed doors. Today, that silence has been replaced by honest conversations about beauty, confidence, ageing, empowerment, and personal choice, as South Africans openly embrace a wide range of aesthetic enhancements. And what South Africans are choosing might surprise you.

Leading plastic and reconstructive surgeon Professor Chrysis Sofianos shares insights from his own practice, revealing how cosmetic surgery trends are evolving across age and race – and what that means for the future of beauty.

“Cosmetic surgery is no longer about fitting a single mould, but about choosing how we, as individuals, want to age, restore, or refine. Today’s patients are more informed, intentional, and unapologetic about their tastes, and wanting to feel good in their own skin,” he says.

Aesthetic choices by age

Gone are the days where cosmetic procedures were the exclusive domain of patients of a certain age. According to Professor Sofianos, the modern approach views aesthetics as a journey, although age still plays a major role in shaping the types of treatments individuals may seek:

  • 20s: Patients in their twenties are often navigating early self-image issues, driven by social media influences. The most requested procedures include breast augmentations, lip fillers, and occasional rhinoplasties to address long-held insecurities.
  • 30s: Often post-pregnancy or in the midst of career and family life, this group leans toward tummy tucks, mommy makeovers, and the start of anti-ageing injections, cosmetic fillers, and preventative treatments. Restoration without exaggeration is usually the goal.
  • 40s: This is the decade of refinement. Liposuction, eyelid lifts, and more assertive facial rejuvenation procedures become common, as patients seek to stay ahead of midlife volume loss and skin laxity.
  • 50s and beyond: For those who want long-term, natural results, the deep plane facelift, neck lifts, and biostimulators become top of mind. “Our approach is structural, not superficial,” he notes. “It’s about restoring facial harmony without compromising identity.”

“What fascinates me is how differently my patients may define beauty. A 22-year-old influencer and a 55-year-old executive might sit in the same waiting room, but their goals couldn’t be more different. We’re not selling a standard look – we’re facilitating personal choices, and sometimes, those choices may even challenge conventional aesthetic norms.”

Understanding patient preferences: A cultural lens

Perhaps the most significant change is how different communities and racial groups are approaching enhancement in South Africa, reflecting new trends in beauty ideals. For example, African women are increasingly choosing breast reductions, prioritising comfort and opting for a different aesthetic from more traditional beauty standards which often favour a fuller figure or more pronounced curves.

Indian patients are leading the way in tummy tucks and body contouring, while Caucasian patients tend to focus on breast augmentations and high-definition liposuction, particularly around the waistline and abdomen, to refine their silhouette and definition.

“What’s beautiful about this shift is how it reflects our diversity. We’re not seeing patients trying to look like someone else – they’re choosing procedures that enhance their natural features and fit their lifestyles,” says Sofianos. “Critically, there is no one-size-fits-all in aesthetic medicine. The more we understand the nuances of each patient’s background and goals, the better we can serve them.”

Why winter is the most strategic time for surgery

No matter your personal objectives, an insider tip could make a huge difference in your surgical recovery: while people mistakenly tend to plan procedures for December – unaware that most surgeons do not operate after November due to holiday closures and the necessity of post-operative care – smart patients are booking for winter.

Cooler temperatures help to reduce swelling, promote easier healing, and generally mean less downtime. Patients also benefit from increased coverage beneath bulkier clothing, allowing them to recover more discreetly while still going about their daily lives. With fewer social commitments and sunnier distractions, winter becomes the ideal window for surgical recovery.

“If you want to look and feel your best by summer, now is the time to plan,” he advises. “Winter is a strategic opportunity for recovery.”

As aesthetic surgery continues to evolve in South Africa, Professor Sofianos believes that education, access, and authenticity are key pillars moving forward.

“My role is to guide patients through their options, help them make informed choices, and deliver results that are both technically excellent and emotionally empowering. The most rewarding part of my practice isn’t about creating one particular look, but about helping people become more confident versions of themselves. Whether that means a subtle enhancement or a more significant change, the choice is truly personal.”

Categories : DermatologyTags : Leave a comment

Long-Term Atopic Dermatitis Treatment Benefits Patients with Delayed Response

On By ModernMedia
Atopic dermatitis in a young patient. Source: NIH

New research from the Icahn School of Medicine at Mount Sinai reveals that patients with moderate-to-severe atopic dermatitis (eczema) who did not initially respond to biologic treatment may still achieve significant clinical improvements with continued therapy.  

The findings, published in the latest issue of Journal of the American Academy of Dermatology (JAAD), highlight the efficacy of extended lebrikizumab treatment up to 52 weeks and pave the way for more personalised, patient-centred approaches to managing this chronic skin condition. 

Lebrikizumab is designed to treat moderate-to-severe eczema by targeting a key source of inflammation in the body. It works by blocking interleukin-13 (IL-13), a protein that plays a central role in the itching, redness, and skin damage seen in atopic dermatitis. 

“This is a significant breakthrough because it shows that people who do not respond to lebrikizumab treatment right away should not give up,” says lead author Professor Emma Guttman-Yassky, MD, PhD, at Mount Sinai. “Initial non-response at 16 weeks does not mean treatment failure. By sticking with treatment longer (52 weeks), most patients saw their eczema improve significantly.” 

Researchers analysed data from two international clinical trials. At 16 weeks, 38.1% of lebrikizumab-treated patients failed to meet strict trial criteria for response. However, 58.1% had already achieved at least a 50% improvement in their Eczema Area and Severity Index (EASI) scores. By 52 weeks, 75.5% had reached a 75% improvement (EASI 75), 44.2% had achieved a 90% improvement (EASI 90), and 66.4% reported a significant reduction in itching. 

“This research supports a more personalised approach to care,” Dr. Guttman-Yassky says. “It offers new hope for patients with difficult-to-treat eczema and may help guide treatment decisions in clinical practice.” 

Source: Mount Sinai Hospital

Categories : Cancer Skeletal SystemTags : Leave a comment

Space-age Lessons Could Protect Childhood Cancer Survivors’ Bone Health

On By ModernMedia
Corresponding author Kiri Ness, PT, PhD, FAPTA, St. Jude Department of Epidemiology and Cancer Control, working with a patient.

Space has inspired and delighted people for centuries. The much-anticipated advent of crewed spaceflight taught invaluable lessons, even for the most unexpected groups back on terra firma. In the 1960s, astronauts returned from microgravity with decreased bone density. This decrease revealed that bones must undergo constant stress to grow and maintain themselves.

Survivors of childhood cancer, while seemingly unrelated to astronauts in the weightlessness of space, are one group unexpectedly impacted by this revelation. These two distinct groups share a connection in the loss of bone density occurring during a significant life event. Children receiving cancer treatment are often sedentary due to their therapy. Their listlessness mimics microgravity’s effect on astronauts, while the treatment itself may also negatively impact their bone health.

Recent research spearheaded by first author Chelsea Goodenough, PhD, St. Jude Department of Epidemiology and Cancer Control, characterised bone mineral density loss in survivors of childhood cancer. Published in JAMA Network Open, her study looked at survivors five or more years after treatment using the St. Jude Lifetime Cohort Study (St. Jude LIFE). She found that survivors were more likely than age-matched peers to experience low bone mineral density. Low bone mineral density predicted a higher chance of lacking independence, including being unemployed or requiring a personal care attendant, highlighting the need to find ways to intervene to protect and promote survivors’ bone health.

“Glucocorticoids given during cancer therapy can act as a giant hammer to bone mineral density,” said corresponding author Kiri Ness, PT, PhD, FAPTA, St. Jude Department of Epidemiology and Cancer Control. “We found that this loss could have long-term consequences for survivors. We saw 30-year-olds that functionally looked like they were in their 70s and 80s, showing the need for early interventions after treatment.”  

Modifiable factors influence survivors’ bone mineral density

“The unique aspect of this study is that we calculated the extent to which different factors contributed to loss of bone density,” Ness said. “That gives us a starting place to design interventions.”

Bone loss decades after treatment could be related to therapy, something investigators can’t change after the fact, but potentially modifiable factors could also be contributing. The St. Jude researchers wanted to see if they could identify any modifiable factors that could point to protective interventions for further investigation.

“We found that about 33% of bone density loss was due to cranial radiation for those who received it,” Ness explained. “But about 25% of the deficit was related to hormone deficiencies, such as hypogonadism.” Hypogonadism is a common consequence of childhood cancer therapy. During treatment, the patient receives hormone-disrupting chemicals, sometimes resulting in an extended deficiency of testosterone or oestrogen and human growth hormone. These three hormones are known to have significant impacts on bone health. Since hormone replacement therapies already exist, the study has identified an area for potential pharmaceutical intervention to address hypogonadism to improve bone density among survivors of childhood cancer. 

Lifestyle changes can impact bone health

“Compared to hypogonadism, smoking and sedentary behaviour were responsible for a smaller but still significant decrease in bone density,” Ness said. “But we already have interventions for both; we just need to test them for their effect on bone mineral density.”

Sedentary behaviour is a common experience during treatment. “Understandably, kids don’t feel good during cancer therapy,” Ness explained. “So, they lay in bed.” Lying in bed acts like microgravity: The kids don’t put stress on their bones, resulting in bone loss. However, survivors can prevent this with physical activity. Exercise has already been shown to help protect cardiovascular health among survivors, so the research provides another potential motivation for exercise.

Ness, whose research focuses on lifestyle interventions to support survivors of childhood cancer, already promotes the positives of physical activity. Her insistence, bolstered by this study, has gained her a reputation among patients. “The kids on the floor call me the ‘exercise lady,’” Ness proudly acknowledged. “When they see me, they say, ‘Here she comes, the exercise lady is here.’”

Physical activity to improve bone health could be as simple as jumping or as elaborate as a dedicated heavy weight-lifting programme. The increased activity will likely promote bone maintenance and, hopefully, growth, a parallel to the exercise programme astronauts undergo upon returning from space to re-establish their bone mass.

While exercise is one way in which survivors can improve their bone health, the study also suggested that those who develop a smoking habit may have one more reason to quit. Survivors who smoked were more likely to have a moderate or severe bone mineral density deficit, along with a host of other problems.

“Smoking is just a bad idea for survivors,” Ness said. “Smoking causes a lot of ill effects, not just bone loss. So, we need to encourage young cancer survivors never to start and give cessation interventions to those that have.” Over 20% of survivors in the study currently smoked, indicating a significant opportunity for intervention.

Better understanding means more chances to help

By attributing the sources of bone mineral density loss, the St. Jude scientists have created a roadmap for exploring potential interventions. The ultimate goal is to give survivors of childhood cancer as much independence as possible to take control of their futures.

“I want survivors to know that if they have low bone mineral density, it’s not an insurmountable problem,” Ness said. “You can be proactive – by being physically active, avoiding smoking and making sure your physician understands your chronic health condition. That’s how you give yourself the best chance of having an independent life as an adult, chasing your dreams.” 

Maybe, one day, they could even become an astronaut.

Written by Alex Generous, PhD.

Source: St. Jude Children’s Research Hospital

Categories : Cardiovascular DiseaseTags : Leave a comment

Dapagliflozin Shows Benefits for Patients with MASH

On By ModernMedia

Results support the potential for dapagliflozin to benefit these patients

Human liver. Credit: NIH

The sodium glucose cotransporter 2 (SGLT-2) inhibitor drug dapagliflozin, widely used to treat type 2 diabetes, also shows improvements for patients with progressive liver disease, according to results of a clinical trial in China published by The BMJ.

The results show that treatment with dapagliflozin improved metabolic dysfunction-associated steatohepatitis (MASH) – a condition where excess fat accumulates in the liver, leading to inflammation – and liver fibrosis compared with placebo.

MASH affects more than 5% of adults, more than 30% of individuals with diabetes or obesity, and can progress to cirrhosis in up to 25% of individuals.

Several studies have reported that SGLT-2 inhibitors can improve liver fat content, liver enzymes, and liver stiffness, but no trial has been carried out among patients with MASH.

To address this, researchers enrolled 154 adults (average age 35; 85% men) diagnosed with MASH after a liver biopsy at six medical centres in China from November 2018 to March 2023.

Almost half (45%) had type 2 diabetes, and almost all had liver fibrosis (33% stage 1, 45% stage 2, 19% stage 3).

After an initial screening biopsy, participants were randomly assigned to receive 10 mg of dapagliflozin or matching placebo once daily for 48 weeks and attended health education sessions twice a year.

Various factors including body weight, blood pressure, blood glucose, liver enzymes, physical activity, diet, insulin, and lipids were also assessed at enrollment and throughout the trial.

MASH improvement was defined as a decrease of at least 2 points in non-alcoholic fatty liver disease activity score (NAS) or a NAS of 3 points or less.

After an end of study biopsy at week 48, 53% (41 of 78) participants in the dapagliflozin group showed improvement in MASH without worsening of fibrosis (defined as no increase in fibrosis stage) compared with 30% (23 of 76) in the placebo group.

Resolution of MASH without worsening of fibrosis occurred in 23% (18 of 78) participants in the dapagliflozin group compared with 8% (6 of 76) in the placebo group.

Fibrosis improvement without worsening of MASH was also reported in 45% (35 of 78) participants in the dapagliflozin group compared with 20% (15 of 76) in the placebo group.

The percentage of participants who discontinued treatment because of adverse events was 1% (1 of 78) in the dapagliflozin group and 3% (2 of 76) in the placebo group.

The researchers acknowledge that the trial was conducted in a Chinese population, which limits its broader generalisability, and that female and older patients were under-represented. But they point out that results were consistent after further analyses, suggesting they are robust.

As such, they conclude: “Our findings indicate that dapagliflozin may affect key aspects of MASH by improving both steatohepatitis and fibrosis.” Large scale and long term trials are needed to further confirm these effects, they add.

The coming years are expected to be particularly exciting in the field of pharmacological treatment for MASH, say researchers from Argentina in a linked editorial.

As more drugs become available, therapeutic decisions will likely become increasingly tailored to individual patient profiles, they write. “Ideally, such treatments should provide cardiovascular benefit, have an established safety profile, and be accessible to broad and diverse patient populations,” they conclude.

Source: BMJ Group

Categories : Metabolic Disorders New Compounds and TreatmentsTags : Leave a comment

New Weight Loss Drug Targets Four Hormone Receptors

On By ModernMedia
Photo by I Yunmai on Unsplash

In the US, drugs like semaglutide are used by over 15 million adults in the U.S., or 4.5% of the population for diabetes and also weight loss. Despite their effectiveness, they have drawbacks. Their effect may not last after discontinuing use, and side effects including osteoporosis and muscle loss have raised concerns about long-term harms. They also induce nausea, which can make it difficult to stay the course of treatment.

Now Tufts researchers led by Professor Krishna Kumar, have designed a new, next-generation compound with hopes that it could be more effective with fewer side effects, which they report in a paper in the Journal of the American Chemical Society. 

While weight loss drugs currently on the market and in development target one, two, or even three hormone receptors related to glucose metabolism and the desire to eat, the Tufts team has identified a fourth target that could potentially further enhance the control strategy.

“Obesity is linked to over 180 different disease conditions, including cancer, cardiovascular disease, osteoarthritis, liver disease, and type 2 diabetes, and affects over 650 million people worldwide,” said Kumar. “What drives us is the idea that we can design a single drug to treat obesity and simultaneously mitigate the risk of developing a long list of health problems plaguing society.”

How the Drugs Work

After a meal, the hormone glucagon-like peptide 1 (GLP-1) is released to help stimulate the production of insulin and the uptake of glucose in muscle and other tissues. With the cells now loaded with fuel, the level of glucose in the blood returns to normal. Semaglutide uses GLP-1 with slight modifications to increase its availability in the bloodstream. Its success in controlling blood glucose has prompted the American Diabetes Association to recommend it and other GLP-1-based drugs as the new first line injectable treatments for diabetes, ahead of insulin.

But GLP-1 also acts directly on the brain, prompting satiety after a meal, and it slows down the rate at which stomach contents are emptied into the intestines, evening out the release of nutrients and glucose into the bloodstream. That’s why it has also become extremely popular as a weight loss treatment.

It’s still not a perfect drug strategy for weight loss, though. “The biggest problem with GLP-1 drugs is that they have to be injected once a week, and they can induce a very strong feeling of nausea,” said Kumar. “As much as 40% of people using these drugs give up after the first month.”

A second hormone released after eating is glucose-dependent insulinotropic peptide (GIP). It also makes us feel full after a meal. GIP looks a lot like GLP-1, so rather than administer two drugs, researchers created one peptide that incorporates structural elements of both – what’s called in drug development a chimera. That drug, tirzepatide, has the added benefit of significantly reducing nausea. As a more tolerable treatment, it may overtake semaglutide in the weight loss market. 

“And then there is a third hormone, glucagon,” said Kumar. “Paradoxically, it actually increases blood glucose, but at the same time increases the expenditure of energy in cells of the body, raises body temperature, and suppresses appetite.” By adding glucagon to the mix, GLP-1 and GIP end up neutralizing its glucose-enhancing effect, leaving the remaining functionalities of all three hormones working together to enhance weight loss.

Glucagon is also similar in structure to GLP-1 and GIP, so drug developers created a single chimera peptide that incorporates elements of all three hormones, which can be recognised by their three separate receptors. That drug, called retatrudide, is currently in clinical trials that indicate even greater achievable weight loss (up to 24%) compared to the original GLP-1 drugs (6-15%).

Going for the Weight Loss Gold Standard with a Fourth Target

“The goal that people are trying to shoot for is bariatric surgery,” said Kumar. That’s a surgical procedure significantly reducing the size of the stomach, which can achieve long-lasting weight loss up to 30%. “For individuals with persistent obesity and potential deadly associated conditions, it becomes a necessary but invasive treatment.” 

Current injectable weight loss drugs still fall short of that gold standard, so the Tufts chemists are focused on a drug redesign that could match the 30% weight loss outcome. 

“There is one more hormone we wanted to bring in to complete a weight control quartet,” said Tristan Dinsmore, a graduate student in the Kumar lab and the lead author of the study. “It’s called peptide YY (PYY). This molecule is also secreted by the gut after we eat a meal, and its job is to reduce appetite and slow the process of emptying food from the stomach, but via different mechanisms than either GLP-1 or GIP. It may also be involved in directly ‘burning off’ fat.”

PYY is from a separate and structurally unrelated class of hormones than the first three, so blending its structure into a chimeric peptide that also mimics GLP-1, GIP, and glucagon was not easy. Instead, the Tufts team was able to join two peptide segments end-to-end, creating a new ‘tetra-functional’ clinical candidate.

“One of the limitations of the current drugs is that individual variation, possibly including how people express target receptors or respond to their corresponding hormones, can lead to lesser than desired weight loss outcomes in many patients,” said Martin Beinborn, visiting scholar in the Department of Chemistry. “By hitting four different hormone receptors at the same time, we hope to improve the chances of averaging out such variation toward the goal of achieving greater and more consistent overall effectiveness.”

“A second issue is that patients tend to regain weight after discontinuing currently available GLP-1 related drugs,” said Beinborn, who notes that lifestyle changes should ideally be a complement to medication treatment. This two-pronged approach will not only support reaching and keeping one’s target weight, but may also help preserve bone and muscle mass.

“Recent studies indicate that weight rebound after drug discontinuation is delayed with the newer, more effective GLP-1 mimetics,” he said. “Extending from this observation, one may speculate that multi-chimeras along the lines of the one we discovered could get us closer to the bariatric surgery standard of lasting weight loss.”

Source: Tufts University