The effect of eflornithine 13.9% cream on the bother and discomfort due to hirsutism

Although unwanted facial hair often leads to anxiety and avoidance of social situations, evaluation of treatment outcomes in clinical trials has relied largely on measures external to the patient such as the extent of hair growth or an expert physician's assessment, neglecting to include patient reported outcomes (PRO). To assess the level of bother caused by a dermatological condition (hirsutism) and changes brought on by treatment, the instrument ESTEEM was developed by expanding the Bother Assessment in Skin Conditions (BASC) scale to six questions to cover the discomfort felt in four social situations and bother due to removing facial hair. Each question elicits responses on a visual analog scale. Women participating in two randomized clinical trials evaluated a new treatment (eflornithine 13.9% cream). Analyses examined the level of bother at each visit, the changes with treatment, the correlations with the Physician's Global Assessment, and the effect size. Hirsutism bothers patients considerably. The mean for overall bother was 89% and the mean discomfort in social situations exceeded 80% in nearly all cases. Treatment led to significant reductions in bother on all six items with effect sizes ranging from 0.46 to 1.62. Eflornithine is an effective treatment for unwanted facial hair in women, as reported by the patients. ESTEEM addresses the specific concerns of women with hirsutism.     

A new treatment of heterotransplanted teeth to prevent progression of root resorption

Abstract A new treatment is suggested to prevent root resorption of heterotransplanted teeth. After conservative root canal treatment, the root surface was treated with concentrated citric acid solution to demineralize the root surface. The demineralized collagenous matrix was then treated with n-acetylcysteine to inhibit collagenase activity and collagen degradation. Two cases are presented. The initial results supported the notion that anti-collagenase drugs might be useful in preventing resorption of mineralized collagenous matrices such as cementum, dentin and bone.     

Predictive Value of Balloon Test Occlusion of the Internal Carotid Artery

Balloon test occlusion (BTO) of the internal carotid artery (ICA) is used in conjunction with single-photon emission computed tomography (SPECT) imaging to assess the cerebrovascular collateral reserve prior to surgical manipulation of the artery. The present report reviews 56 consecutive patients with tumors or vascular lesions at the base of the skull who underwent BTO and subsequent treatment on that basis within a 3-year period. Four patients underwent carotid sacrifice, since they tolerated the BTO and had normal SPECT imaging. Postoperatively, one patient had patchy infarcts in the frontal lobe, another a middle cerebral artery territory infarction, a third had a lacunar infarct, and the fourth had an impending stroke and was treated with an emergent revascularization procedure. There were 15 patients who underwent saphenous vein bypass grafting, of these there were three graft occlusions, one of which resulted in an infarction. There were two other infarctions due to technical difficulties, one being related to the revascularization procedure. Based on these results, we suggest that passing BTO with a normal SPECT study does not necessarily indicate that the patient is immune to stroke following carotid sacrifice. Revascularization should be considered, when ICA sacrifice is deemed necessary to treat the pathologic condition adequately, to minimize the likelihood of a stroke.     

Pyoderma Gangrenosum and Sterile Multifocal Osteomyelitis Preceding the Appearance of Takayasu Arteritis

Abstract: A 9-month-old infant had pyoderma gangrenosum (PG) and sterile osteomyelitis. Three years later the patient developed Takayasu arteritis (TA). Sterile osteomyelitis was reported in approxitnately 30 patients with different skin lesions, but never together with pyoderma gangrenosum. The association of PG and TA has been reported rarely, and then maiitly in adults or in children over age 9 years. This rare association should alert physicians with a case of infantile PG of unknown etiology to consider the possible diagnosis of TA.     

不同地域患者罗库溴铵药效学的比较多中心研究

目的比较中国、奥地利和美国3个不同地域的当地患者罗库溴铵作用的量效关系和时效关系。方法选择中国大连、美国英格伍德、奥地利格拉茨3个医学中心择期手术患者各18例,异丙酚、芬太尼静脉麻醉诱导后,累积剂量法进行药效学观察,首剂静脉注射罗库溴铵50μg/kg,起效后重复首剂静脉给药6次,再静脉注射罗库溴铵300μg,采用肌机械运动监测仪记录肌肉收缩强度,对数剂量．概率单位绘制剂量-反应曲线。比较3个地域患者罗库溴铵的ED50、ED90和ED95以及Dur25和Dur0．8。结果大连和格拉茨患者罗库溴铵的ED50、ED90和ED95均高于英格伍德患者,格拉茨患者的ED50、ED90和ED95高于大连患者（P＜0．05）;大连和格拉茨患者的Dur25和Dur0．8均短于英格伍德患者（P＜0．05）,格拉茨患者的Dur25短于大连患者（P＜0．05）,但两者Dur0．8的差异无统计学意义（P＞0．05）。结论3个地域患者罗库溴铵作用的量效关系和时效关系有明显的差别,临床用量需要考虑地域因素的影响。     

Interactive effects of the serotonin transporter 5-HTTLPR polymorphism and stressful life events on college student drinking and drug use.

BACKGROUND: A common functional polymorphism, 5-HTTLPR, in the serotonin transporter gene has been associated with heavy drinking in college students. We examined this polymorphism as it interacted with negative life events to predict drinking and drug use in college students. METHODS: Daily reports of drinking and drug use obtained using a daily web-based survey were combined with self-reports of past-year negative life events and 5-HTTLPR genotypes in a regression analysis of alcohol and nonprescribed drug use in a sample of 295 college students. RESULTS: Genotype and negative life events significantly interacted in relation to drinking and drug use outcomes. Individuals homozygous for the short (s) allele who experienced multiple negative life events in the prior year reported more frequent drinking and heavy drinking, stronger intentions to drink, and greater nonprescribed drug use. In individuals homozygous for the long (l) allele, drinking and drug use were unaffected by past-year negative life events. Heterozygous subjects showed drinking outcomes that were intermediate to the two homozygous groups. CONCLUSIONS: The 5-HTTLPR s-allele is associated with increased drinking and drug use among college students who have experienced multiple negative life events. The s-allele carriers may be at risk for a variety of adverse behavioral outcomes in response to stress.