The use of dermoscopy in differentiating Sister Mary Joseph nodule and cutaneous endometriosis

https://ift.tt/2Erz1td

Dermoscopic pre‐ and posttreatment evaluation in patients with androgenetic alopecia on platelet‐rich plasma—A prospective study

Summary

Background

Platelet‐rich plasma is rich in growth factors that promote differentiation and growth of dermal papilla cells by various signaling pathways. Dermoscopy is handy, bedside tool that helps to improve diagnostic accuracy in various hair disorders.

Objectives

To evaluate and study the role of dermoscopy in patients with androgenetic alopecia (AGA) pre‐ and posttreatment with platelet‐rich plasma (PRP).

Methods

It is a prospective comparative study. Twenty male patients with AGA, aged 18‐45 years with modified Norwood‐Hamilton classification grade II‐VI were included in this study. Patients were given platelet‐rich plasma injections every 3 week for a period of 3 months. Dermoscopy was performed with 10 x magnifications in polarized mode at baseline and at 3 months from the baseline and photographs were taken. Patients were evaluated based on following dermoscopic findings (a) hair count, (b) hair density, (c) hair diameter diversity, perifollicular pigmentation, yellow dots, multi‐hair follicular units, honeycomb pigment pattern and white dots, (d) patient's hair growth assessment score.

Results

Posttherapy, patients showed significant improvement in hair count (27.4%), hair diversity (84.2%), increase in number of thick, terminals hairs, reduction in yellow dots (60%), perifollicular pigmentation (92.3%) was appreciated. Hair pull test negative after treatment in 10 patients (50%). Patient's hair growth assessment score showed 50%‐75% improvement in 7 (35%) patients.

Conclusion

Dermoscopy helps to easily evaluate and compare the therapeutic response pre‐ and posttreatment which can be easily documented and visualized at every visit.

https://ift.tt/2CgSHOJ

Research on the changing trend of the carbon footprint of residents’ consumption in Beijing

Abstract

Emission of greenhouse gas is a global environmental problem. In recent years, China has been facing growing international pressure because of its large energy consumption and elevated greenhouse gas emissions. As the capital of China, Beijing is central to the study of carbon emission reduction since its carbon emissions have ranked at the forefront nationwide. The existing literature mainly revolves around carbon emissions of a few specific years, and there is a lack of trend study of multiple years in Beijing. This paper, based on the input-output method, calculates carbon emissions in Beijing by carbon footprints; the changing trend analysis was carried out by researching available statistical data of three years, 2002, 2007, and 2012, from the perspective of the entire city of Beijing and from that of urban and rural residents' consumption. The reasons for the changing trends of total carbon emission in Beijing have also been analysed using the Structural Decomposition Analysis (SDA) model. Results show that the total direct carbon footprint as well as the urban and rural direct carbon footprints of residents' consumption in Beijing is all increasing gradually. The direct carbon footprint of urban residents' consumption is mainly produced by electricity, gasoline, and heating power, while that of rural residents' consumption is mainly produced by raw coal and electricity. The indirect carbon footprint of residents' consumption in Beijing is increasing gradually, and that of urban areas is higher than that of rural areas. The compositions of indirect carbon footprints of rural and urban residents' consumption are consistent, and both come mainly from the transportation and communication industry, housing, food, culture, education, entertainment, etc. The SDA results show that the per capita consumption level is the main driving factor for the increase of the indirect carbon footprint of Beijing residents' consumption, and the intensity of CO₂ emission is the main inhibiting factor. Finally, suggestions for reducing carbon emissions from urban and rural perspectives have been put forward.

https://ift.tt/2PHArl5

Subcutaneous expanders and synthetic mesh for breast reconstruction: long-term and patient reported BREAST-Q outcomes of a single center prospective study

Recently, prepectoral breast reconstruction is experiencing a revival. Despite of the growing body of early reports about subcutaneous breast reconstruction, literature lacks of long term results and studies focusing on patient-reported outcomes and heath related quality of life (HRQOL).Between January 2012 and December 2016, patients undergoing mastectomy were enrolled at our Institution. We selected patients diagnosed for breast cancer or genetic predisposition to breast cancer, undergoing conservative mastectomy, either nipple-sparing (NSM) or skin-sparing mastectomy (SSM), willing for prepectoral tissue expander reconstruction assisted by a synthetic mesh.

https://ift.tt/2CivxaZ

Evolving role of Surgeons with the use of implant based breast reconstruction

We read with great interest the article written by Poole et al1 and it was interesting to note the outcome of implant-based breast reconstructive surgery particularly with time. It appears that cosmetic dissatisfaction, pain and capsular contracture were the main contributing factors. Their complication rates compare favourably with the National mastectomy and the Implant based breast reconstruction (IBRA) audit findings.

https://ift.tt/2SPxi4M

The Influence of Social Media on Women Undergoing Immediate Breast Reconstruction

With nearly four-fifths of the United States population utilizing social media, these networks are quickly becoming a tool for physicians to disseminate and patients to find information.1 While it is likely that social media is one of the sources through which breast reconstruction patients seek and obtain information, this has never been assessed. The goal of this study was to determine which, if any, social media sources were influencing women's choice in breast reconstruction and which were the most influential sources of information.

https://ift.tt/2CeDuh6

The effect of target speed on perception of visual motion direction in a patient with akinetopsia

Publication date: Available online 15 December 2018

Source: Cortex

Author(s): Joost Heutink, Gera de Haan, Jan-Bernard Marsman, Mart van Dijk, Christina Cordes

Abstract

Although much research has been devoted to the neural correlates of motion perception, the processing of speed of motion is still a topic of discussion. Apart from patient LM, no in-depth clinical research has been done in the past 20 years on this topic. In the present study, we investigated patient TD, who suffered from the rare disorder akinetopsia due to bilateral lesions of V5 after stroke. By means of a Random-Dot-Kinematogram (RDK) in which speed was varied systematically, it was found that TD was impaired in perceiving the direction of movement at speeds exceeding 9 deg/s. Our study suggests that V5 plays an important role in processing high-speed visual motion and further implies that V5 does not play a crucial role in processing low-speed visual motion. A remarkable finding, which has not been shown before, was that TD always reported the opposite direction of the actual movement at a speed of 24 deg/s. This suggests a form of the continuous wagon wheel illusion, which might have been caused by intact brain areas operating at different sampling rates than area V5.

https://ift.tt/2Ev3KGF

Sensory-motor integration and brain lesions: Progress toward explaining domain-specific phenomena within domain-general working memory

Publication date: Available online 15 December 2018

Source: Cortex

Author(s): Candice C. Morey

Abstract

Reports of rare patients who seem to lack the ability to retain certain types of information across brief delays have long sustained the popular idea that newly-perceived verbal, visual, and spatial information is initially recorded in separate, specialized short-term memory buffers. However, evidence from these same cases includes puzzling details that question explanations based on isolated deficits to a specialized storage system. We highlight consistent findings from patients with deficient auditory short-term memory that warrant further investigation and may challenge the specialized store account, including that short-term recognition memory performance appears to be much stronger than recall, and not so obviously impaired. We also describe the substantial problems for the broader memory system caused by assuming that the patients' deficits are focused in a specialized module. We suggest that a sensory-motor integration account of the patient cases may adequately explain these patterns, and therefore presents a path toward incorporating into the embedded processes framework greater clarity about how domain-specific phenomena in immediate memory tasks arise. We further contend that applying ideas about sensory-motor recruitment could improve working memory theory.

https://ift.tt/2Elwrot

Neural correlates of effort-based behavioral inconsistency

Publication date: Available online 15 December 2018

Source: Cortex

Author(s): Javier Bernacer, Ivan Martinez-Valbuena, Martin Martinez, Nuria Pujol, Elkin Luis, David Ramirez-Castillo, Maria A. Pastor

Abstract

According to the theory of value-based decision making, subjects tend to choose the most valuable among a set of options. However, agents may not be consistent when facing the same decision several times. In this paper, Shannon's entropy (H) is employed as a measure of behavioral inconsistency: it is a central measure of information theory that, applied to decision making, allows the estimation of behavioral preferences among a set of options. We scanned (functional magnetic resonance imaging, fMRI) 24 young (18-25 year) subjects (14 female) while performing a decision-making task, where monetary rewards were devalued by physical effort (minutes running in the treadmill) and risk. Twenty different pairs of options were presented nine times each, and H was calculated for each pair and subject. Behavioral analyses showed that subjective value (SV) significantly explained agents' preferences only in pairs with a low inconsistent response. Averaged response time positively correlated with H, confirming entropy as an indicator of choice difficulty. Group analyses on fMRI data revealed a cluster in the paracingulate cortex as the neural correlate of H. Besides, BOLD signal in the posterior cingulate correlated with the SV of the pair only in consistent decisions, confirming that SV loses its explanatory power on highly inconsistent decisions. Finally, the anterior and central cingulate were especially recruited when predicting a secured effortless reward, compared with a secured reward that involved a maximum effort. Our study shows that different regions of the cingulate cortex are involved in choice inconsistency, SV and processing effort costs.

https://ift.tt/2Elwgtj

Anatomical predictors of successful prism adaptation in chronic visual neglect

Publication date: Available online 15 December 2018

Source: Cortex

Author(s): Marine Lunven, Gilles Rode, Clémence Bourlon, Christophe Duret, Raffaella Migliaccio, Emmanuel Chevrillon, Michel Thiebaut de Schotten, Paolo Bartolomeo

Abstract

Visual neglect is a frequent and disabling consequence of right hemisphere damage. Previous work demonstrated a probable role of posterior callosal dysfunction in the chronic persistence of neglect signs. Prism adaptation is a non-invasive and convenient technique to rehabilitate chronic visual neglect, but it is not effective in all patients. Here we aimed to assess the hypothesis that prism adaptation improves left neglect by facilitating compensation through the contribution of the left, undamaged hemisphere. We assessed the relationship between prism adaptation effects, cortical thickness and white matter integrity in a group of 14 patients with unilateral right-hemisphere strokes and chronic visual neglect. Results showed that patients who benefitted from prism adaptation had thicker cortex in temporo-parietal, prefrontal and cingulate areas of the left, undamaged hemisphere. Additionally, these patients had a higher fractional anisotropy value in the body and genu of the corpus callosum. Results from normal controls show that these callosal regions connect temporo-parietal, sensorimotor and prefrontal areas. Finally, shorter time intervals from the stroke tended to improve patients' response to prism adaptation. We concluded that prism adaptation may improve left visual neglect by promoting the contribution of the left hemisphere to neglect compensation. These results support current hypotheses on the role of the healthy hemisphere in the compensation for stroke-induced, chronic neuropsychological deficits, and suggest that prism adaptation can foster this role by exploiting sensorimotor/prefrontal circuits, especially when applied at early stages post-stroke.

https://ift.tt/2ExU3XM

Initiation of methotrexate with or without a test dose: a retrospective toxicity study

Publication date: Available online 15 December 2018

Source: Journal of the American Academy of Dermatology

Author(s): Thomas Herrmann, Michael Buhnerkempe, Morgan L. Wilson

https://ift.tt/2UOoMF2

Guselkumab in the Treatment of Hidradenitis Suppurativa: A Retrospective Chart Review

Publication date: Available online 15 December 2018

Source: Journal of the American Academy of Dermatology

Author(s): Rachel G. Casseres, Jared S. Kahn, Min Ji Her, David Rosmarin

https://ift.tt/2UNyGa0

Flush technique to minimize adverse reactions from syringe lubricant (silicone oil)

Publication date: Available online 15 December 2018

Source: Journal of the American Academy of Dermatology

Author(s): Carlos Gustavo Wambier, Evelyn Assis de Andrade, Luiza Stolz Cruz, Bruna Mikulis Lemes, Wayne D. Carey, Bárbara de Paula Silveira Moura, Alessandro Soares Both, Sarah Perillo de Farias Wambier, Flavio Luis Beltrame

https://ift.tt/2PE1s93