Changes in proinflammatory gene expression in human whole blood after contact with UV-conditioned implant surfaces

Abstract

Objectives

The aim of this in vitro study was to assess changes in the gene expression of proinflammatory cytokines in human whole blood after contact with titanium implant surfaces conditioned by UV light. To this end, expression levels of proinflammatory cytokines were analyzed in vitro in human whole blood.

Materials and methods

Dental implants made of grade 4 titanium were conditioned by UV light in a UV device and submerged in human whole blood. Unconditioned implants served as controls, and blood samples without implants served as the negative control group. Sampling was performed at 1, 8, and 24 h. Changes in the expression levels of interleukin-1β (IL1B) and tumor necrosis factor alpha (TNF) were assessed using RT-qPCR at the mRNA level.

Results

The gene expression of IL1B was significantly suppressed in the test group over the observation period compared to the control group during the 1–8 h after having contact between the implant surface and the blood. The gene expression of TNF was not significantly altered by UV conditioning after 1 and 8 h of observation, but both cytokine expression levels were increased significantly after 24 h.

Conclusions

Differences in the gene expression of proinflammatory cytokines after insertion of UV-conditioned titanium implants can be assessed using a human whole blood test. UV-conditioned implant surfaces apparently suppress the release of IL1B in vitro.

Clinical relevance

The results of our publication demonstrate that modulation of the early inflammatory response in human whole blood is possible by surface treatment with UV light. In particular, the suppression of IL1B expression, especially after the initial contact of blood cells, may be beneficial in the osseointegration of titanium implants by positively influence the balance between rejection and acceptance of an implant.

http://bit.ly/2CBQTPt

Raman spectroscopy applications in rheumatology

Abstract

Raman spectroscopy is a type of vibrational spectroscopy based on the inelastic scattering of photons, which has attracted much attention due to its potential clinical application in rheumatology. In this review, we discuss the typical spectral features of cartilage, bone, synovial fluid, and pathologic crystal deposits, as well as methods of amplifying the Raman signal of biofluids such as drop-coating deposition Raman spectroscopy. Further, applications of Raman and drop-coating deposition Raman spectroscopy in osteoarthritis are described, highlighting the clinical potential of these methods. We also discuss the role of Raman and related techniques in analyzing pathologic crystals such as monosodium urate, calcium pyrophosphate dihydrate, and hydroxyapatite. The results presented in this review demonstrate that Raman spectroscopy has grown past the stage of proof-of-concept, especially in the case of pathologies involving crystal depositions such as gout and calcium pyrophosphate deposition disease , for which the method has been validated on large number of samples. As the medical community becomes more and more aware of Raman spectroscopy, it is envisioned that it will become a standard technique in the near future.

http://bit.ly/2HnNqtj

Cosmetics, Vol. 6, Pages 6: Role of PGE-2 and Other Inflammatory Mediators in Skin Aging and Their Inhibition by Topical Natural Anti-Inflammatories

Cosmetics, Vol. 6, Pages 6: Role of PGE-2 and Other Inflammatory Mediators in Skin Aging and Their Inhibition by Topical Natural Anti-Inflammatories

Cosmetics doi: 10.3390/cosmetics6010006

Authors: Bryan Fuller

Human skin aging is due to two types of aging processes, “intrinsic” (chronological) aging and “extrinsic” (external factor mediated) aging. While inflammatory events, triggered mainly by sun exposure, but also by pollutants, smoking and stress, are the principle cause of rapid extrinsic aging, inflammation also plays a key role in intrinsic aging. Inflammatory events in the skin lead to a reduction in collagen gene activity but an increase in activity of the genes for matrix metalloproteinases. Inflammation also alters proliferation rates of cells in all skin layers, causes thinning of the epidermis, a flattening of the dermo-epidermal junction, an increase in irregular pigment production, and, finally, an increased incidence of skin cancer. While a large number of inflammatory mediators, including IL-1, TNF-alpha and PGE-2, are responsible for many of these damaging effects, this review will focus primarily on the role of PGE-2 in aging. Levels of this hormone-like mediator increase quickly when skin is exposed to ultraviolet radiation (UVR), causing changes in genes needed for normal skin structure and function. Further, PGE-2 levels in the skin gradually increase with age, regardless of whether or not the skin is protected from UVR, and this smoldering inflammation causes continuous damage to the dermal matrix. Finally, and perhaps most importantly, PGE-2 is strongly linked to skin cancer. This review will focus on: (1) the role of inflammation, and particularly the role of PGE-2, in accelerating skin aging, and (2) current research on natural compounds that inhibit PGE-2 production and how these can be developed into topical products to retard or even reverse the aging process, and to prevent skin cancer.

http://bit.ly/2S1qnc2

Nipple leiomyoma: a rare neoplasm with a broad spectrum of histologic appearances

Cutaneous leiomyomas are rare benign smooth muscle tumors. These lesions are differentiated based on their cell of origin and are sub‐classified as pilar leiomyoma, angioleiomyoma, and genital leiomyoma. Nipple leiomyomas are the least common genital leiomyoma, arising from the dartoic muscle cell of the nipple. Histologic examination of the lesion is necessary for definitive diagnosis, and these uncommon tumors can pose a diagnostic challenge. We describe herein a series of six nipple leiomyomas with a spectrum of histologic appearances.

This article is protected by copyright. All rights reserved.

http://bit.ly/2QZzLbD

Low dose Isotretinoin as an adjuvant therapy for treatment of different clinical variants of warts: a case series

Abstract

Warts constitute the most frequently observed dermatological manifestations of human papillomavirus (HPV). Although an extensive range of treatments exists for local warts, there is no specific therapy based on high‐quality evidence of notable treatment success or high cure rate, or minimal adverse effects. Recalcitrant warts are, therefore, a common therapeutic problem. This case series refer to 14 immunocompetent patients with recalcitrant warts, who experienced full resolution of their warty lesions when treated with addition of low dose isotretinoin, in a dose of 0.1‐0.2 mg/kg/day, for a 3‐month course, with no significant adverse effects. Long‐term remission was noted for up to 3 years with no signs of active lesions. Low dose isotretinoin should be in the priority of the treatment options of recalcitrant warts, alone or in‐combination.

This article is protected by copyright. All rights reserved.

http://bit.ly/2sAxmKH

Increased synthesis of hyaluronic acid by enhanced penetration of CTP‐EGF recombinant in human keratinocytes

Summary

Background

Epidermal growth factor (EGF) plays an important role in regeneration and proliferation of skin cells. It synthesizes fibrous proteins, such as collagen, and induces the proliferation of keratinocytes and fibroblasts. It can also induce hyaluronic acid synthesis, which subsequently leads to improved skin elasticity, wrinkle improvement, and moisturizing effects. Thus, the EGF is an attractive cosmetic additive for skin care.

Objectives

We tested the use of cytoplasmic transduction peptide (CTP) as a delivery peptide for EGF into skin cells. Additionally, we characterized the skin permeability of CTP‐EGF for its potential use in skin antiaging and antiwrinkle cosmetics.

Methods

Skin penetration by recombinant CTP‐EGF protein was confirmed using fluorescent imaging techniques. The ability to synthesize hyaluronic acid was confirmed by immunoblotting and ELISA.

Results

CTP‐EGF displayed cell membrane permeability and could penetrate skin cells. Treatment with CTP‐EGF increased collagen protein formation, which is a major regulator of skin elasticity. Further, CTP‐EGF treatment led to increased expression of HAS3 enzyme and subsequently boosted hyaluronic acid synthesis. The CTP‐EGF also performed better than natural EGF in wound healing assays.

Conclusions

CTP‐EGF has a superior ability, compared with natural EGF, to permeate skin and induce hyaluronic acid synthesis and collagen formation. Thus, it has great potential to be used in cosmetics and therapeutic agents to improve wrinkles and health of the skin.

http://bit.ly/2Holw0u

Effects of lactobionic acid peel, aluminum oxide crystal microdermabrasion, and both procedures on skin hydration, elasticity, and transepidermal water loss

Summary

Background

Topical applications of alpha‐hydroxy acids and poly hydroxy acids in the form of peels gained popularity. To enhance the effect of these substances, aluminum oxide crystal microdermabrasion can be used in one procedure.

Aims

The assessment of skin hydration, elasticity, and TEWL after using lactobionic acid in the form of 20% peel and lactobionic acid in the form of 20% peel combined with aluminum oxide crystal microdermabrasion.

Material and methods

The study involved 20 Caucasian female subjects. Six treatments were performed at weekly intervals, using the Split face method—20% LA was used on the left side of the face and aluminum oxide crystal microdermabrasion followed by 20% LA application on the right side of the face.

Results

Corneometric measurement showed statistically significant differences between the hydration level for sessions 1 and 3 and 1 and 6. A higher hydration level was found on the side with the combined procedure. Tewametric measurement showed that the TEWL values were different for sessions 1 and 3 and 1 and 6—they decreased. There were no statistically significant differences between the two procedures. The cutometric measurement indicated statistically significant differences between skin elasticity for pairs in session 1 and 3 and 1 and 6.

Conclusions

The results of the study indicate that the combination of LA peel with microdermabrasion increases its moisturizing effect and improves skin elasticity. The use of both procedures also contributed to the decrease in TEWL; however, greater exfoliation of the epidermis in combined procedures resulted in slightly higher TEWL values.

http://bit.ly/2S1krQi

Periorbital pigmentation: An alarming sign of metabolic syndrome

Abstract

Periorbital pigmentation is a commonly encountered condition which presents clinically as bilateral round, oval or semicircular homogenous dark brown pigmented macules in the periocular region. It may influence quality of life of an individual with its strong psychological impact. We present a case of middle‐aged female patient, who had periorbital pigmentation as a manifestation of acanthosis nigricans. On evaluation, she was found to have hypertension, hyperglycemia, and dyslipidemia and she fulfilled the criteria for metabolic syndrome. We believe, it is important to evaluate the patients who present as periorbital pigmentation with clinical features of acanthosis nigricans for underlying metabolic syndrome.

http://bit.ly/2HnFBE3

Solitary and Multiple Epidermolytic Acanthoma: A Demographic and Clinical Study of 131 Cases

BACKGROUND

Epidermolytic acanthoma (EA) is a rare, benign acquired cutaneous keratosis displaying epidermolytic hyperkeratosis in more than 50% of its surface. Due to the sparsity of comprehensive studies, little is known on the patient demographics and clinical characteristics of this uncommon entity. We wish to comprehensively characterize the clinical and demographic features of EA and to differentiate it from its mimickers.

METHODS

We carried out a retrospectively review of 131 cases of EA, recorded clinical and histopathologic features and performed linear regression of yearly incidence rates to assess for possible under‐reporting of this entity.

RESULTS

EA affected both genders equally. We found 9.08 cases per 100,000 biopsy specimens per year and linear regression analysis demonstrated significant decreasing incidence rates. Analysis of the anatomical site distribution of EA lesions demonstrated a more frequent genital location in men (39.1% of cases in men, as compared to 11.3% for women). Contrary to previous studies, lesions were most frequently single (91.7%) and the mean age of presentation was 57.8 years.

CONCLUSION

The presented largest case series to‐date indicates that EA is likely an underdiagnosed entity and establishes the demographic and clinical features of EA.

This article is protected by copyright. All rights reserved.

http://bit.ly/2T0C289

Influence of metal-based cerium oxide nanoparticle additive on performance, combustion, and emissions with biodiesel in diesel engine

Abstract

Biodiesel has been renowned as potential and alternative fuel for years. In order to improve the quality of the conventional fossil fuels, biodiesel, and air pollution from combustion, additives are essential to exploit. In this study, the uses of cerium oxide (CeO₂) nanoparticle additive for B20 fuel in a diesel engine are investigated. The CeO₂ nanoparticles with cetyl-trimethyl ammonium bromide are doped into the B20 fuel by using ultrasonicator. The purpose of the experimental work was adopted to enhance engine combustion and reduce the emissions with an approach of CeO₂ nanoparticle additive. The experiment was conducted on a diesel engine using different propagation of CeO₂ nanoparticle in blended mahua methyl ester fuel such as B20 + CeO₂ 50 ppm, B20 + CeO₂ 100 ppm, and B20 + CeO₂ 150 ppm. The obtained results are compared with the diesel and B20 fuels. The minor changes are obtained in B20 fuel properties due to the addition of CeO₂ nanoparticles. The performance of brake thermal efficiency and combustion of pressure data is observed to be enhanced by the addition of a metal-based additive. The CO, HC, and smoke are decreased for B20 fuel with nanoparticles. The NO_x is reduced by dosing the CeO₂ due to the oxidation of unburned CeO₂ in the exhaust.

http://bit.ly/2sEgGBQ

Long‐term outcomes of imiquimod‐treated lentigo maligna

Summary

Background

Lentigo maligna (LM) may be disfiguring and can progress to LM melanoma. Surgical excision remains the mainstay of treatment, but may result in disfigurement when used for large facial lesions. Topical imiquimod is a nonsurgical alternative although data on its long‐term efficacy remain limited.

Aim

To assess long‐term outcomes of LM treated with imiquimod cream.

Methods

We collected data retrospectively for 33 patients treated with imiquimod cream for biopsy‐proven LM from 2001 to 2016. Patients initially applied imiquimod once daily, 5 days/week for 6 weeks, aiming to produce a brisk local inflammatory response. If there was no response, the dose was increased to twice daily 7 days/week for 6 weeks and if again there was no response, to twice daily for 10 weeks.

Results

An inflammatory response developed in 29 (88%) of the 33 patients, and of these, 4 patients stopped treatment earlier than planned because they could not tolerate the inflammatory reaction, while 3 patients reported systemic side effects. There was lesion clearance in 21 (72%) of the 29 patients, and they remained clear after a mean follow‐up of 4.1 years. Eight failed to clear; in five the lesion was excised, while the remaining three were managed expectantly.

Conclusions

Our results support the use of imiquimod as an alternative to surgery for the treatment of LM in selected cases. With adequate patient preparation, imiquimod is generally tolerated and can achieve excellent cosmetic results. A clinical response is more likely if there is a brisk inflammatory response, and LM will not resolve if there is no inflammatory response.

http://bit.ly/2MlGBYd

Modified phenol peels for treatment‐refractory hyperpigmentation of lichen planus pigmentosus: A retrospective clinico‐dermoscopic analysis

Abstract

Background

Lichen Planus Pigmentosus (LPP), a disorder with stubborn treatment‐refractory hyperpigmentation predominantly affects the darker skin. Deep dermal pigmentary incontinence of LPP renders the condition treatment‐refractory.

Objectives

Lack of a consistently effective depigmenting treatment protocol of inactive LPP mandates exploration of novel approaches. We analyzed the effect of six sessions of modified phenol peel on reduction of pigmentation of LPP in Indian patients.

Methods

The results of a retrospective analysis of the efficacy and safety of six sessions of Croton oil free phenol combination (CFPC) peel done every 3 weeks, for inactive LPP‐associated hyperpigmentation in 17 patients are presented. Efficacy evaluation was done with patient‐reported improvement, physician‐evaluated improvement (photographic comparison of baseline and post‐treatment clinical images), and pre‐ and posttreatment comparison of dermoscopic images using a simple scale.

Results

Out of 17, 5 (29%) patients sustained excellent improvement with >75% reduction of pigmentation. Overall 13 (76%) patients had moderate to excellent improvement, that is, at least 25% or more reduction in pigmentation. The patient‐reported improvement, physician‐graded improvement, and dermoscopic changes—all three measures showed harmonious overlap. Lightening of the background color and reduction in density and color intensity of pigmented structures was observed on dermoscopy in majority of patients. The treatment was well tolerated with no serious local/systemic adverse effects.

Conclusions

Modified phenol peels seem effective in reduction of hyperpigmentation of LPP. They are safe and well tolerated. Thorough priming, stringent sun protection and use of post‐peel adjuvant topicals boost the peel effect and aid in maintaining the effect for up to a year.

http://bit.ly/2U5wUzL

A comparison of infection rates during skin cancer excisions using nonsterile vs sterile gloves: A prospective randomized pilot study

Summary

Background

Standard surgical skin excision is a routine outpatient procedure commonly performed in Dermatology practice to treat nonmelanoma and melanoma skin cancer. Use of sterile gloves during this procedure has been the standard of care in most Dermatology offices.

Objective

To determine whether the incidence of infection rates was affected when using nonsterile gloves (NSG) instead of sterile gloves (SG) during standard skin excisions in an outpatient Dermatology clinic setting.

Methods

This prospective, subject‐blinded, single‐center trial randomized 93 patients presenting for routine skin cancer excisions into two groups. In the first group, 53 excisions were performed with NSG and in the second group 53 excisions were performed with sterile gloves. Degree of wound inflammation and wound infection at 48‐72 hours postprocedure was measured.

Results

One hundred and six total wounds were included. Zero of 53 were infected in the NSG group, and 0/53 were infected in the SG at the initial screening 48‐72 hours postexcision procedure (P = 0.99). The average wound inflammation score was 0.321 for the NSG group and 0.245 for the SG group.

Conclusions

Our study suggests that NSG are safe to use for simple excisions of cutaneous skin cancers in an outpatient dermatology clinic setting.

http://bit.ly/2DnHj4c

Fueling Ketone Metabolism Quenches Salt-Induced Hypertension

Publication date: Available online 19 January 2019

Source: Trends in Endocrinology & Metabolism

Author(s): David E. Place, Thirumala-Devi Kanneganti

Understanding the molecular mechanisms by which diet and exercise regulate disease has the potential to help identify new treatments. In their recent study, Chakraborty et al. (Cell Reports 2018;25:677–689) discovered that supplementation with a metabolic precursor produced β-hydroxybutyrate (BHB), counteracting the pathological effects of high-salt diet-induced hypertension, suggesting a new treatment modality.

http://bit.ly/2TbMI3G

Pressure Ulcers: Prevention and Management

Publication date: Available online 18 January 2019

Source: Journal of the American Academy of Dermatology

Author(s): Joshua S. Mervis, Tania J. Phillips

Abstract

Prevention has been a primary goal of pressure ulcer research. Despite such efforts, pressure ulcers remain common in hospitals and the community. Moreover, pressure ulcers often become chronic wounds that are difficult to treat and tend to recur after healing. Especially given these challenges, dermatologists should have the knowledge and skills to implement pressure ulcer prevention strategies and to effectively treat pressure ulcers in their patients. This continuing medical education article will focus on pressure ulcer prevention and management, with a particular emphasis on the evidence for commonly accepted practices.

http://bit.ly/2FL68st

Pressure Ulcers: Pathophysiology, Epidemiology, Risk Factors, and Presentation

Publication date: Available online 18 January 2019

Source: Journal of the American Academy of Dermatology

Author(s): Joshua S. Mervis, Tania J. Phillips

Abstract

Though preventable in the vast majority of cases, pressure ulcers continue to pose a major burden to the individual and society, affecting up to 3 million adults annually in the United States alone. Despite increased national attention over the past 20 years, the prevalence of pressure ulcers has largely remained unchanged, while associated costs of care continue to increase. Dermatologists can play a significant role in pressure ulcer prevention by becoming aware of at-risk populations and implementing suitable preventive strategies. Moreover, dermatologists should be able to recognize early changes that occur prior to skin breakdown and to properly identify and stage pressure ulcers so as to prevent delay of appropriate care. The aim of the first part of this continuing medical education article is to discuss the pathophysiology, risk factors, epidemiology, social and economic burden, and clinical presentation of pressure ulcers.

http://bit.ly/2FCeof5

A novel technique to safely maximize botulinum toxin extraction from 50 unit vials

Publication date: Available online 18 January 2019

Source: Journal of the American Academy of Dermatology

Author(s): Isadore S. Tarantino, Brett C. Neill, Melanie N. Wolf, Anand Rajpara, Daniel J. Aires

http://bit.ly/2FJMEV0

Detection of increased intracerebral lactate in a mouse model of Leigh syndrome using proton MR spectroscopy

Publication date: Available online 19 January 2019

Source: Magnetic Resonance Imaging

Author(s): Yusuke Takahashi, Hidetaka Kioka, Yasunori Shintani, Akiko Ohki, Seiji Takashima, Yasushi Sakata, Takahiro Higuchi, Shigeyoshi Saito

Abstract

Purpose

To establish a brain proton magnetic resonance spectroscopy (¹H MRS) experimental system using a mouse model of Leigh syndrome for monitoring intracerebral lactate levels as a biomarker of mitochondrial disease progression.

Materials and methods

Brain ¹H MRS was performed in the Ndufs4 homozygous knockout (KO) mice, a mouse model of Leigh syndrome, and control mice on a horizontal 7.0-T magnetic resonance imaging system at age 5–9 weeks. In a subset of KO mice, survival analysis was performed according to the median of the intracerebral lactate levels. In addition, in KO mice alive until 9 weeks of age, both ¹H MRS and T₂-weighted imaging (T₂WI) were longitudinally performed in the same individuals at 5, 7, and 9 weeks of age.

Results

Brain ¹H MRS demonstrated increased lactate levels in KO mice compared with control mice (6.4 ± 1.2 mM vs. 3.3 ± 0.8 mM, p < 0.0001). The increased intracerebral lactate levels were already observed at 5 weeks of age, while no obvious abnormal findings were detected in T₂WI. Notably, an increased lactate level of >5.94 mM at week 5 was associated with a poor prognosis (median survival days: 24.5 vs. 42 days, log-rank p = 0.03). Longitudinal ¹H MRS experiments revealed temporal increase of intracerebral lactate levels, peaking at week 7 (mean change: 2.6 ± 0.7 mM, p = 0.001), followed by decrease at week 9 (mean change: −3.8 ± 2.5 mM, p = 0.03), along with further disease progression, with brain lesions being detected on T₂WI.

Conclusion

Using brain ¹H MRS, we demonstrated significant increase in intracerebral lactate levels in a mouse model of Leigh syndrome. Additionally, we demonstrated that intracerebral lactate is a useful biomarker of mitochondrial disease progression at stages preceding the development of brain lesions.

http://bit.ly/2TXc7ya

Mass spectrometry‐based proteomics reveals the distinct nature of the skin proteomes of photoaged compared to intrinsically aged skin

Abstract

Objective

With increasing age skin is subject to alterations in its organisation, which impacts on its function as well as having clinical consequences. Proteomics is a useful tool for non‐targeted, semi‐quantitative simultaneous investigation of high numbers of proteins. In the current study we utilise proteomics to characterise and contrast age‐associated differences in photoexposed and photoprotected skin, with a focus on the epidermis, dermal‐epidermal junction and papillary dermis.

Methods

Skin biopsies from buttock (photoprotected) and forearm (photoexposed) of healthy volunteers (aged 18‐30 or ≥65 years) were transversely sectioned from the stratum corneum to a depth of 250 μm. Following SDS‐PAGE, each sample lane was segmented prior to analysis by liquid chromatography‐mass spectrometry/mass spectrometry. Pathways analysis was carried out using Ingenuity IPA.

Results

Comparison of skin proteomes at buttock and forearm sites revealed differences in relative protein abundance. Ageing in skin on the photoexposed forearm resulted in 80% of the altered proteins being increased with age, in contrast to the photoprotected buttock where 74% of altered proteins with age were reduced. Functionally, age‐altered proteins in the photoexposed forearm were associated with conferring structure, energy and metabolism. In the photoprotected buttock proteins associated with gene expression, free‐radical scavenging, protein synthesis and protein degradation were most frequently altered.

Conclusion

This study highlights the necessity of not considering photoageing as an accelerated intrinsic ageing, but as a distinct physiological process.

This article is protected by copyright. All rights reserved.

http://bit.ly/2DmIQHW

ΒΟΗΘΗΜΑΤΑ ΑΚΟΗΣ,ΑΚΟΥΣΤΙΚΑ ΒΑΡΗΚΟΙΑΣ,ΕΝΙΣΧΥΤΕΣ ΑΚΟΗΣ

Οπισθωτιαία
Εφαρμόζονται πίσω από το αυτί και συνδέονται με το κατάλληλο εκμαγείο

Ενδοκαναλικά
Αθέατα,Είναι μικρότερα σε μέγεθος και εφαρμόζονται μέσα στον ακουστικό πόρο.

Καθαρή και διαυγή μετάδοση της φωνής των συνομιλούντων
Έξυπνη φραγή των θορύβων

Άριστη ποιοτική ενίσχυση και απόδοση του ήχου,εύκολα στη χρήση,άνετα στην εφαρμογή,όμορφα για καλύτερη αισθητική όσο αφορά το μέγεθος και την εξωτερική εμφάνιση,χωρίς καμμία ιδιαίτερη συντήρηση.

Ενδοωτιαίο Ακουστικό Βοήθημα με ελεγχόμενη ένταση,
Ενδοωτιαίο Ακουστικό Βοήθημα Υψηλής Πιστότητας,
Ενδοωτιαίο Ακουστικό Βοήθημα Δώρο Χαράς Σε Όσους Αγαπάτε και Φροντίζετε,
Ενδοωτιαίο Ακουστικό Βοήθημα με πιστοποίηση γνησιότητας και ποιότητας,
Ενδοωτιαίο Ακουστικό Βοήθημα υποαλλεργικά άριστης εφαρμογής,
Ενδοωτιαίο Ακουστικό Βοήθημα όμορφα μικρά αόρατα με άριστες αποδόσεις,
Ενδοωτιαίο Ακουστικό Βοήθημα όμορφα μικρά αόρατα με άριστες αποδόσεις για μεσαίες εως υψηλές βαρηκοΐες,
Ενδοωτιαίο Ακουστικό Βοήθημα Οδηγίες Χρήσης,

https://akoustika-ellas.blogspot.com/,
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Οπισθοωτιαίο Ακουστικό Βαρηκοίας υψηλής ποιότητας,
Οπισθοωτιαίο Ακουστικό Βαρηκοίας υψηλής ποιότητας επαναφορτιζόμενο,
Οπισθοωτιαίο Ακουστικό Βαρηκοίας υψηλής ποιότητας επαναφορτιζόμενο με έξυπνη φραγή όλων των θορύβων,
Οπισθοωτιαίο Ακουστικό Βαρηκοίας υψηλής ποιότητας επαναφορτιζόμενο με μπαταρία μακράς διάρκειας,

https://akoustika-ellas-2.blogspot.com/,
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Οπισθοωτιαίο Ακουστικό Βαρηκοίας υψηλής ποιότητας επαναφορτιζόμενο με έξυπνη φραγή όλων των θορύβων με μπαταρία μακράς διάρκειας,
Οπισθοωτιαίο Ακουστικό Βαρηκοίας υψηλής ποιότητας επαναφορτιζόμενο με έξυπνη φραγή όλων των θορύβων με επεξεργαστή IC Extra Low Noise,
Οπισθοωτιαίο Ακουστικό Βαρηκοίας υψηλής ποιότητας επαναφορτιζόμενο με έξυπνη φραγή όλων των θορύβων με επεξεργαστή IC sound processing technology,
Οπισθοωτιαίο Ακουστικό Βαρηκοίας υψηλής ποιότητας επαναφορτιζόμενο με έξυπνη φραγή όλων των θορύβων με επεξεργαστή IC Extra Low Noise με μπαταρία μακράς διάρκειας και γρήγορης φόρτισης,
Οπισθοωτιαίο Ακουστικό Βαρηκοίας υψηλής ποιότητας επαναφορτιζόμενο με μπαταρία μακράς διάρκειας 12 εως 18 ωρών φόρτιση σε θύρα USB,
Οπισθοωτιαίο Ακουστικό Βαρηκοίας υψηλής ποιότητας επαναφορτιζόμενο με έξυπνη φραγή όλων των θορύβων με επεξεργαστή IC Extra Low Noise με μπαταρία μακράς διάρκειας και γρήγορης φόρτισης 5γρ εύκολη χρήση,

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