Calcium Hydroxylapatite versus Nonanimal Stabilized Hyaluronic Acid for the Correction of Nasolabial Folds: A 12-Month, Multicenter, Prospective, Randomized, Controlled, Split-Face Trial

BACKGROUND Fillers continue to proliferate in dermatology. Rigorous clinical trials can help determine the advantages and disadvantages of these products as they come to market.
OBJECTIVE This randomized, split-face, controlled study compared the efficacy, safety, durability, and volumes of calcium hydroxylapatite (CaHA) versus nonanimal-stabilized hyaluronic acid (NASHA) in nasolabial folds.
METHODS AND MATERIALS Sixty patients were enrolled at two medical clinics in Europe (Summer 2005). Patients received two injections 3 months apart. Patients returned at 6, 9, and 12 months for a blinded evaluation, using accepted aesthetic rating scales. Adverse events were recorded throughout the study.
RESULTS At all time points, CaHA was found to be more effective than NASHA. At 12 months, 79% of CaHA folds were still improved or better versus 43% of NASHA folds ( p <.0001). In addition, 30% less total CaHA volume was required compared to NASHA. Evaluators assessed CaHA as superior in 47% of patients and inferior in only 5% ( p <.0001). Blinded evaluators and patients preferred CaHA two to one ( p <.05). Both products were safe and well tolerated.
CONCLUSION CaHA was found to be significantly more effective than NASHA. At all time points, CaHA demonstrated longer lasting results and greater improvement than NASHA.     

Synthesis,biological activity and isomerism of guanylate cyclase C-activating peptides guanylin and uroguanylin

Recently, the peptides guanylin and uroguanylin were identified as endogenous ligands of the membrane-bound guanylate cyclase C (GC-C) that is mainly expressed in the intestinal epithelium. In the present study, bioactive guanylin and uroguanylin have been prepared by solid-phase methodology using Fmoc/HBTU chemistry. The two disulfide bonds with relative 1/3 and 2/4 connectivity have been introduced selectively by air oxidation of thiol groups and iodine treatment of Cys(Acm) residues. Using this strategy, several sequential derivatives were prepared. Temperature-dependent HPLC characterization of the bioactive products revealed that guanylin-related peptides exist as a mixture of two compounds. The isoforms are interconverted within approximately 90 min, which prevents their separate characterization. This effect was not detected for uroguanylin-like peptides. Synthetic peptides were tested for their potential to activate GC-C in cultured human colon carcinoma cells (T84), known to express high levels of GC-C. The results obtained show that both disulfide bonds are necessary for GC-C activation. The presence of the amino-terminally neighboring residues of Cys104 for guanylin and Cys100 for uroguanylin has been found to be essential for GC-C stimulation. Unexpectedly, a hybrid peptide obtained from substitution of the central tripeptide AYA of guanylin by the tripeptide VNV of uroguanylin was not bioactive. © Munksgaard 1997.     

Behavioural intervention practices for stereotypic and repetitive behaviour in individuals with autism spectrum disorder: a systematic review

Aim The purpose of this systematic review was to examine the quality of conduct of experimental studies contributing to our empirical understanding of function‐based behavioural interventions for stereotypic and repetitive behaviours (SRBs) in individuals with autism spectrum disorders (ASDs). Method Systematic review methodology was used to identify relevant articles, to rate the level of evidence and quality of conduct of the studies, and to extract data systematically. Results Ten single case studies examining 17 participants (14 males, 3 females; age 2y 11mo–26y) diagnosed with various ASDs were included. Overall, studies reported decreases in SRBs using behavioural interventions and some collateral increase in desirable behaviours. Interpretation Only a small number of intervention studies for SRBs explicitly state the function of the behaviour; therefore, relatively little is known about the efficacy of SRB interventions in relation to the range of possible behavioural functions. Evidence supporting SRB interventions is preliminary in nature, and caution should be used in choosing and implementing SRB intervention practices for individuals with ASDs.     

A more reliable index of sunscreen protection, based on life table analysis of individual sun protection factors

The efficacy indices of two representative sunscreen preparations were determined using life table analysis of individual sun protection factors (SPF), obtained by exposing a group of subjects to ultraviolet radiation (UVR) doses from 4 to 20 multiples of the control minimal erythema dose (MED). The ultimate efficacy index is expressed as the UVR dose under which a selected percentage of the population is safely protected by a sunscreen. This method takes into account several sources of bias in the current test procedure, in particular the considerable variability in individual responses. It also takes into account subjects in whom the MED of the protected skin is either higher or lower than the range of challenge doses to which they were exposed, thereby increasing the effective sample size. This method provides a more precise and comprehensive index of sunscreen protection, and enables statistical comparison of different preparations, or of the effect of other factors on their efficacy.