Background and objectives: There are no large volume comparative studies available to compare the efficacy of lasers over lights for hair removal in Fitzpatrick V and VI skin types. This study is designed to compare the efficacy of Nd:YAG laser versus IPL in the darker skin types. Study design/materials and methods: Thirty-nine patients included in Group-1 were treated with Nd:YAG and 31 in Group-2 with IPL. Both groups received 5 sessions of treatment. The hair counts were assessed using digital photography and manual counting method before and after treatment and the results were analysed. Patient satisfaction scores and pain scores were recorded in each session and compared. Results: Mean hair reduction in the IPL group was 25.70 and Nd:YAG group was 24.12 (95% CI). In the Nd:YAG group, 59% of subjects had burning sensation while the figure was 32.3% in IPL group. Burning was less in IPL group (p < 0.023). There were no statistically significant differences noticed regarding hyperpigmentation in both the groups (p < 0.115). Conclusion: Both Nd:YAG and IPL are equally effective for epilation of the darker skin types. Nd:YAG is associated with mild burning sensation in a significant number of patients. Patient satisfaction scores were comparable in both the groups. 相似文献
Background: The relationship between microbiology and histology in patients with ventilator-associated pneumonia has been sparsely described.
Methods: Twenty-five patients who died in the intensive care unit after their lungs had been mechanically ventilated for 72 h were studied. Twenty of the 25 died with clinical suspicion of pulmonary infection. A total of 375 immediate postmortem pulmonary biopsies were obtained after death and processed for quantitative microbiology and histology. Four evolutionary stages of pneumonia were defined: early, intermediate, advanced, and resolution.
Results: At least one specimen with histologic evidence of pneumonia was found in all but two patients (92%). Histologic pneumonia was a widespread and frequent process (46% of biopsies examined) involving predominantly the lower lobes (55% of all biopsies with pneumonia) and showing different histopathologic stages of progression coexisting in the same lung lobes. Lung cultures were frequently polymicrobial (149 of 375, 40% of the pulmonary biopsy cultures, and 20 of 25, 80% of the cases) and not always yielding the same pathogen (19 microorganisms) when comparing one lung to the other. Histopathology and microbiologic biopsy cultures showed a weak relationship (28% and 49% of species had counts greater or equal to 103 cfu/g in samples without pneumonia from patients with and without prior antibiotic treatment, respectively). Histopathologic evolutionary stages were not associated with any differences in quantitative culture results of pulmonary biopsies, independently of prior administration of antibiotics. Higher bacterial concentrations of biopsy cultures were associated with the absence of prior antibiotic treatment. 相似文献
A case of double aortic arch that was well visualized using transthoracic echocardiography is reported. A 38‐year‐old man underwent transthoracic echocardiography for the evaluation of dyspnea. A suprasternal view of transthoracic echocardiography showed the ascending aorta bifurcate to left and right aortic arches, with blood flow from the ascending aorta to bilateral aortic arches. The diagnosis of right side–dominant double aortic arch was made, and the patient's symptom was conceivably related to compression of the trachea due to a vascular ring. This report indicates the potential usefulness of transthoracic echocardiography for noninvasive detection of double aortic arch in adults. 相似文献
High accrual to clinical trials enables new treatment strategies to be tested rapidly, accurately and with generalisability.
Ethical standards also must be high so that participation is voluntary and informed. However, this can be difficult to achieve
in trials with complex designs and in those which are closely embedded in clinical practice. Optimal recruitment requires
a balance of both ethical and accrual considerations. In the context of a trial of stratified treatments for children with
acute lymphoblastic leukaemia (UKALL2003) we examined how recruitment looked to an observer and how it felt to the parents,
to identify how doctors' communication could promote or inhibit optimal recruitment. 相似文献
1,3-Butadiene is a carcinogen in rodents, but its potential carcinogenicity
to humans remains controversial. Numerous studies have shown that butadiene
and its metabolites cause sister chromatid exchanges in vitro and in vivo.
To test for other types of genotoxicity, the micronucleus assay and
fluorescence in situ hybridization (FISH) have been used to detect
chromosome damage in human lymphocytes caused by two reactive metabolites
of butadiene, diepoxybutane (DEB) and monoepoxybutene (MEB). DEB (0.5-5.0
microM) significantly increased micronucleus formation 4- to 6-fold (P
<0.01) and MEB (1-500 microM) by 2- to 4-fold (P <0.01) over control
levels. The ability of DEB and MEB to induce aneuploidy of chromosomes 7,
8, 12, and X was examined using dual-color FISH in both interphase and
metaphase cells. These chromosomes were chosen because of their involvement
in leukemogenesis. Both DEB and MEB caused dose-dependent increases in
hyperdiploidy of chromosomes 12 and X, but had no discernible effect on
chromosomes 7 and 8. These results suggest that DEB and MEB cause
chromosome-specific aneuploidy in human cells. If formed in sufficient
amounts, DEB and MEB may produce chromosome damage of the type found in
leukemia following exposure to butadiene.
相似文献
Six children presenting with partial growth hormone (GH) deficiency (mean GH peak in two different tests, 8.0 k1.3 μ g/l ) aged 8–10.3 years (mean, 2.7 ± 0.9 years) were treated for 6 months by continuous subcutaneous infusion of GH-releasing hormone(1–29)-NH, (GHRH(1–29)-NH2); 24-hour GH profiles and height velocity were measured. A biphasic effect of GHRH(1–29)-NH2 infusion was observed. After an early substantial increase in the 24-hour integrated concentration of GH, from 1.6 ± 0.1 to 3.5 ± 0.7 μg/l/minute, a subsequent consistent decrease occurred by 3 months, which was more pronounced after 6 months (mean 24-hour integrated concentration of GH, 1.9± 0.9 μg/l/minute). This effect reflects modification of both pulse amplitude and frequency of GH secretion. At the end of the study, one child had complete suppression of GH secretion and two others showed only one peak above 5 μg/1 during a 24-hour period. No correlation was found between these changes and height velocity. Three children did not grow significantly; the other three children who had a growth response to GHRH(1–29)-NH2 were those with the lowest 24-hour integrated GH concentration at the end of the study. The possible mechanisms involved in this biphasic effect, including GHRH antibodies, changes in somatostatin levels and/or desensitization of pituitary GHRH receptors, have been investigated. 相似文献