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Selected AbstractsLactic Acid Chemical Peels as a New Therapeutic Modality in Melasma in Comparison to Jessner's Solution Chemical PeelsDERMATOLOGIC SURGERY, Issue 12 2006KHALIFA E. SHARQUIE MBCHB BACKGROUND Many chemicals have been used in the skin peeling for melasma such as Jessner's solution and glycolic acid. Lactic acid is an ,-hydroxy acid that has not been used before in chemical peeling of melasma. OBJECTIVE The purpose of the present work was to evaluate the efficacy and safety of lactic acid in chemical peeling of melasma in comparison to Jessner's solution chemical peels. METHODS This study was conducted at the Department of Dermatology and Venereology, Baghdad Hospital, in the period between April 2001 and August 2002. Thirty patients with melasma were included in this study. They were mostly of skin type IV according to Fitzpatrick's classification, 26 (86.67%) were women, and 4 (13.33%) were men, with an age range from 18 and 50 years (mean±SD, 33.53±6.96 years). Full clinical examination was done to all patients including Wood's light. The severity of melasma was assessed by MASI (Melasma Area Severity Index). Pure lactic acid full strength (92%, pH 3.5) was used as a new peeling agent on the left side of the face while Jessner's solution was applied to the right side of the face. The chemical peeling sessions were done every 3 weeks until the desired response was achieved. Follow-up was carried out for 6 months after the last session. RESULTS Six patients were defaulted from the study after the first session for unknown reasons. Twenty-four patients completed the study. Twenty (83.33%) were women and four were men (16.67%). Wood's light examination showed increased contrast in all patients of mostly epidermal melasma. The number of sessions ranged from 2 to 5. All patients showed marked improvement as calculated by MASI score before and after treatment, and the response was highly statistically significant. No side effect was recorded in all treated patients. CONCLUSION Lactic acid was found to be an effective and safe peeling agent in the treatment of melasma, and it was as effective as Jessner's solution. [source] Delayed visual P3 in unilateral thalamic strokeEUROPEAN JOURNAL OF NEUROLOGY, Issue 5 2000E. Trinka The P3 potential is accepted as a neurophysiological correlate of memory and attention. Delayed latencies were reported in different forms of dementias. Although the generator sites are still under debate, the thalamus may play a crucial role. The aim of this study was to investigate the influence of an unilateral thalamic ischaemic infarction on P3 generation. The event-related P3 component of six patients (2 male, four female; mean age 47 years, range 22,63 years) with unilateral thalamic ischaemic infarction was studied and compared to age-matched controls (five male, nine female; mean age 45.8 years; range 22,69 years). All patients underwent full clinical examination, CCT, and MRI scan. P3 potentials were recorded with a visual three stimulus discrimination paradigm. The mean P3 latency of the patient group to the target stimulus was delayed (469.7 ms, SD = 36.8) compared with the controls (378.8 ms, SD = 51.5; P < 0.05). The mean P3 latency to the unexpected stimulus was delayed in patients with thalamic infarction compared with controls [477 ms (SD = 46.6) vs. 381.2 ms (SD = 48.5); P < 0.001). Delayed P3 components of the event-related potential (ERP) were recorded in six patients with unilateral thalamic infarction, suggesting an important role of the thalamus in the generation of the P3 potential. [source] A nationwide study on hospital admissions due to dehydration in exclusively breastfed infants in the Netherlands: its incidence, clinical characteristics, treatment and outcomeACTA PAEDIATRICA, Issue 5 2009Rolf AA Pelleboer Abstract Aims: To estimate the incidence and clinical characteristics in hospital admissions due to dehydration or undernutrition and their laboratory evaluation and treatment outcome in exclusively breastfed infants. Methods: All hospital admissions during the first 3 months of life assessed by the Dutch Paediatric Surveillance Unit (DPSU) between mid 2003 and mid 2005. Results: Nationwide 158 cases reported, correspond to an incidence of 58/y/100 000 breastfed infants; it is lower for severe dehydration at risk for hypernatraemia; 20/y/100 000. Sixty-five per cent of cases were <2 weeks old, their median weight loss was 9.3% and median age at admission 5 days; Serum sodium value was measured in only 12% of all cases. Insufficient volume intake and inadequate growth were most frequently reported (61% and 41%). Lethargy, jaundice or clinical dehydration was scored in 11,25%, seizures or shock in 3%. A breast pump at home was used in only 31%. In the hospital breast pumps were available (82%) as lactation consultants (73%). For treatment 65% was offered formula, in 30% by nasogastric drip. Most admissions lasted up to 3 days, all recovered fully and 33% were breastfed exclusively at discharge. Conclusion: The incidence of severe dehydration in the Netherlands is relatively low. With extended use of breast pumps at home it could be lower. To prevent complications, we recommend applying a reference weight chart, a full clinical examination and more extensive screening of serum sodium and glucose. [source] Staging and management of cutaneous T-cell lymphomaCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 2 2006J. J. Scarisbrick Summary Cutaneous T-cell lymphoma (CTCL) accounts for two-thirds of cases of primary cutaneous lymphoma. Most variants of CTCL are indolent lymphoma, the most common being mycosis fungoides. In addition, Sézary syndrome, the leukaemic variant, has an aggressive clinical course. Accurate diagnosis and staging is critical in determining the prognosis of those with CTCL. The tumour, node, metastasis and blood stage needs to be documented and used to determine an overall stage from IA to IVB. Management of patients should be carried out by a multidisciplinary team. A full clinical examination should be made at all visits. Thorough investigations are needed at diagnosis and should be repeated during disease progression to allow initial staging and restaging. Treatment of patients with early-stage disease (IA,IIB) should be limited to skin-directed therapy. More advanced or resistant disease may be treated with systemic therapies such as extracorporeal photopheresis, immunotherapy, monoclonal antibody therapy, novel retinoids or chemotherapy, and where possible, patients should be entered into clinical trials. [source] | ||||||||||