Adverse effects associated with influenza vaccination in patients with COPD: a randomized controlled study

OBJECTIVE: The aim of this study was to assess the frequency and type of adverse reactions following influenza vaccination and its effects on lung function, dyspnoeic symptoms, exercise capacity, and clinical acute respiratory illness (ARI) in patients with COPD, and the relationship of these adverse effects to the degree of airflow obstruction. METHODOLOGY: A stratified, randomized, double-blind placebo-controlled study was conducted over an 18-month period at a single university hospital. In total, 125 patients with COPD were randomized to the vaccine group (62 patients who received purified trivalent split-virus vaccine injections) or the placebo group (63 patients). Local and systemic symptoms during the week following the injections were evaluated. Clinical ARI, lung function tests, dyspnoeic symptoms (assessed using a visual analogue scale), and a 6-min walking test were evaluated before and at 1 week and 4 weeks following vaccination. RESULTS: The frequency of local adverse reactions was 27% in the vaccine group and 6% in the placebo group (P = 0.002). There was no significant difference in systemic adverse reactions between the vaccine and placebo groups (76% vs. 81%; P= 0.5). No difference was observed in the incidence of ARI between the vaccine and placebo groups during the first week (6.4% vs. 6.3%; P= 1) and the first 4 weeks (24.2% vs. 31.7%; P= 0.5) following vaccination. There was no significant change in lung function, dyspnoeic symptoms, and exercise capacity of the patients in both groups, at 1 week and 4 weeks following vaccination, regardless of the severity of COPD. CONCLUSION: Influenza vaccination is associated with minimal local adverse reactions in patients with COPD. Vaccination does not cause systemic adverse reactions, induce clinical exacerbations or adversely affect lung function, dyspnoeic symptoms and exercise capacity in patients with COPD, regardless of the severity of airflow obstruction.     

The efficacy and safety of a combined multipolar radiofrequency with pulsed electromagnetic field technology for the treatment of vaginal laxity: a double-blinded,randomized, sham-controlled trial

Lasers in Medical Science - Non-invasive vaginal rejuvenation with radiofrequency (RF) and lasers devices have gained popularity, but well-designed studies confirming their effectiveness are...     

A Novel Technique of Supra Superficial Musculoaponeurotic System Hyaluronic Acid Injection for Lower Face Lifting

Background: Various methods attempting to correct sagging of the lower face focus mainly on manipulation of the superficial musculoaponeurotic System. Each technique has its own limitation. The authors propose a relatively simple, conservative method utilizing hyaluronic acid injection just above the superficial musculoaponeurotic System. Objective: To address a novel hyaluronic injection technique to lift the lower face. Methods: Details of the injection techniques are described. The Position of the hyaluronic acid injected and the effect of hyaluronic acid on the superficial musculoaponeurotic System were confirmed by ultrasonography in one of the cases. Results: Sonogram images demonstrated the location of the injected hyaluronic acid and pressure effect of hyaluronic acid on the superficial musculoaponeurotic System, confirming the ability to manipulate the superficial musculoaponeurotic System by this injection technique. The lifting result of this Single injection technique was immediately visible and maintained for at least 26 weeks. Conclusion: This is a less invasive, reproducible method that provides a sustained face lifting result. The authors propose the term “supraSMAS lift” for this novel injection technique.Facial aging is a complex and continuous process that affects the skin and underlying tissues through intrinsic and extrinsic factors.1 Significant physical signs of lower face aging include varying degrees of laxity, sagging, prominent nasolabial folds, and marionette lines.The superficial musculoaponeurotic system (SMAS) is one continuous, organized fibrous network in the face connecting the facial muscles with the dermis. It consists of a three-dimensional architecture of collagen fibers, elastic fibers, fat cells, and muscle fiber located in the subcutaneous layer and is connected to the dermis by vertical fibrous septa from the fat lobules.2 Over the area of the retaining ligament of the face, the connection of SMAS and dermis is made by part of retaining ligaments called “retinacular cutis.”3 The SMAS extends upward to blend with the temporoparietal fascia and downward to the superficial cervical fascia.4 The thickness of SMAS varies among individuals and among different regions of the face.4 It is easily identified at the lateral part of the face, particularly over the parotid gland and temporal region and becomes thinner and gradually disappears in the midface.4Surgical face lift techniques that aim to manipulate the SMAS can be simply categorized into SMAS imbrication, lateral SMASectomy with plication, and SMAS elevation.5 Although there is no consensus to which approach is the best, in general surgical face lift has been the Standard treatment of the sagging face. However, the main limitations of surgical face lift are risk of complications, longer recovery time, and the enormous Variation in the skill and experience of the individual surgeon.6 In recent years, nonsurgical skin tightening methods have been developed.7 Among the several modalities, a noninvasive microfocused ultrasound (MFU) has been recently introduced as a novel energy-based transcutaneous heat delivery system that reaches the deeper subdermal connective tissue in tightly focused zones at consistent programmed depths.8,9 The delivery of MFU to targeted areas in the SMAS results in immediate contraction of denatured collagen with subsequent initiation of neocollagenesis and collagen remodeling, leading to a durable lifting and tightening result.10,11 Nevertheless, the cost of MFU and pain during the procedure are considered as limitations for some patients. In this article, the authors propose another less invasive method of hyaluronic acid (HA) injection in the level above the SMAS, aiming to cause a mechanical effect to SMAS, which will produce a lower face lifting effect.     

Calcinosis cutis presenting years before other clinical manifestations of juvenile dermatomyositis: Report of two cases

Calcinosis cutis in dermatomyositis is dystrophic calcification appearing late in the course of the disease. Two cases are reported here of calcinosis cutis that presented years before other clinical manifestations of juvenile dermatomyositis. The first case was a 14-year-old Thai girl who had asymptomatic subcutaneous nodules that spontaneously ruptured, exuding a chalky discharge and healing with an atrophic scar 8 years before the onset of other clinical manifestations of juvenile dermatomyositis; that is, Gottron's papules, proximal muscle weakness grade IV/V with atrophy, slightly elevated serum creatinine phosphokinase level and an abnormal electromyogram compatible with myopathy. The second case was a 15-year-old Thai boy who had calcinosis cutis 3 years before the onset of other clinical manifestations of juvenile dermatomyositis, and the calcinosis cutis was so severe that it interfered with the movement of his extremities. Both cases responded well to aluminium hydroxide therapy.     

Prevalence of polycystic ovary syndrome in Thai University adolescents

Polycystic ovarian syndrome (PCOS) is a common and complex condition characterized by endocrine features and influenced by genetic and environmental factors. In Southeast Asia and Thailand, the prevalence of PCOS is unknown. The aim of this study was to estimate the prevalence of and determine factors associated with PCOS in Thai adolescents. We administered a validated questionnaire to 600 university female participants aged 17–19 years from Mahidol University in Bangkok. Of these, 548 (91.33%) responded and agreed to participate. Two-hundred and seventy-nine girls (50.91%) were identified as likely having PCOS and defined as ‘probable cases’. Of those 279 participants, 248 (88.88%) were evaluated further for PCOS using the Rotterdam criteria. A complete history was taken, and a physical examination including trans-abdominal ultrasound was performed. Blood chemistry tests were performed to exclude similar conditions and to investigate potential co-morbidities. The prevalence of PCOS in Thai adolescents was found to be 5.29%. After multivariate analyses, moderate acne was the strongest risk factor for PCOS. The odd ratios (95% confidence interval) for the presence of mild acne, moderate acne, and oligo- or amenorrhea in participants with PCOS were 2.83 (1.01–7.90; p?=?.47), 31.69 (10.07–99.67; p?p?相似文献   

Side effects and complications of fractional 1550-nm erbium fiber laser treatment among Asians

Background Fractional erbium fiber laser is an effective treatment for facial wrinkles, acne scars, and dyspigmentation available worldwide. However, there are minimal data of adverse events and complications in Asians. Objective To determine safety and adverse events associated with fractional erbium laser treatment in Asian patients. Methods Retrospective data of 181 fractional 1550‐nm Ytterbium/Erbium fiber laser (Finescan^?; TNC Medditron Co., Ltd., Thailand) from 119 patients with skin phototype III–V at Ramathibodi Laser Center were reviewed. Patient demographics including gender, age, and dermatologic indications for treatment were assessed. Safety and adverse effects related to the treatment were identified. Results Only six treatments (3.3%) developed complications. The most common adverse event was postinflammatory hyperpigmentation (2.2%), while acneiform eruption and desquamation were reported 0.55%, equally. Although none of the patients received herpes prophylaxis, there were no herpes outbreaks. Conclusion Fractional erbium laser treatment in Asian skin is quite safe, and the side effects in this study were relatively low. Herpes prophylaxis may not be required.