Simple Steps Improve Appearance After Thyroid Surgery
November 10, 2007
July 16 — Cosmetic surgery approaches can lead to better aesthetic outcomes for patients having thyroid surgery, researchers report.
The thyroid is a small butterfly-shaped gland located in the neck.
Dr. David Terris, chair of the department of otolaryngology-head and neck surgery at the Medical College of Georgia, in Augusta, studied 248 patients who underwent thyroid surgery. He noted that many patients are concerned about their appearance after the surgery.
“It matters to them how big the scar is, if it’s even, if it’s hidden in a skin crease, if the edges are nicely aligned,” Terris said in a prepared statement.
He found “that while keeping the management of the underlying thyroid problems as the first priority, we can still achieve a maximal cosmetic result.”
One simple tip is to have patients sit or stand while incision sites are marked, so that the incision sites better blend into the natural lines of the body.
“You want the incision to be in a location that corresponds to a cosmetically favorable area when you are upright at a dinner party, not stretched out on an operating room table,” Terris said.
Other cosmetic surgery techniques that can help improve aesthetic outcomes among thyroid surgery patients include:
- Trimming traumatized edges at the incision sites
- Using surgical glues instead of sutures
- Minimizing trauma to surrounding skin
- Minimizing use of drains to manage post-surgery oozing.
Terris’ team published its findings in the July issue of The Laryngoscope.
SOURCE: Medical College of Georgia, news release, July 9, 2007
Patients happy with laser skin treatments - study
November 10, 2007
Apr 17 - Most patients undergoing non-ablative laser skin surgery appear to be satisfied with the results of the treatment, according to a new study.
Laser surgery is used to treat a variety of cosmetic and non cosmetic skin conditions. It involves the use of lasers that cut, seal or vaporize skin tissue and blood vessels in the affected area. There are a number of lasers used to treat skin conditions, some of which are considered less invasive than others.
Laser skin treatments are becoming increasingly popular, especially for the treatment of acne scarring and photoaging . In a recent study, researchers measured patient satisfaction following laser treatments for these conditions with a neodymium:yttrium-aluminum-garnet laser. The Nd:YAG is considered a non-ablative rejuvenation system. It treats scarred and damaged skin by stimulating collagen production. It also produces a cooling spray which helps prevent damage to the skin.
In comparison, invasive lasers treat skin conditions by removing the outer layers of skin to promote the growth of new skin. Non-ablative laser treatments are gaining interest because they are associated with less risk for adverse effects such as infection, scarring and pigmentary changes, when compared to invasive lasers. They also produce gradual improvement instead of sudden effects.
The researchers conducted interviews with 34 patients from the same practice. Each patient had previously received a series of six monthly treatments with a 1,320 nanometer Nd:YAG laser for treatment of acne scarring or photoaging. The interviews were conducted at least three months after treatment had ended.
After reviewing their data, the researchers found that 62 percent of the patients reported being satisfied with treatment. In addition, 31 percent reported improvement in the texture of the skin at the end of the six treatments. When the results were re-evaluated based on the specific condition being treated, the researchers found a slightly higher satisfaction rate among those with acne scarring. When asked to rate their overall degree of improvement on a 1 to 10 scale, the average rate for acne scarring was 5.4, while 3.8 was reported for wrinkling. The researchers believe this discrepancy could be due to higher expectations among photoaging patients.
These findings are significant because they suggest that the majority of patients undergoing non-ablative laser treatment for acne scarring and photoaging are satisfied with the improvement seen in their skin. The data also suggests that physicians can improve satisfaction rates by ensuring that their patients have realistic expectations for the outcomes of their laser skin treatment.
Details of the study were released by the American Society for Dermatologic Surgery in a Mar. 31, 2007 press release. The study appears in the March 2007 issue of Dermatologic Surgery.
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New antimicrobial wound treatment shows promise
November 10, 2007
Apr 17 - Researchers have developed a compound that destroys bacteria and fungi without damaging tissue. The product has shown effectiveness in animal testing and may be approved for use on humans in the future.
Wounds are breaks in the skin or mucous membranes. They can be caused by a wide range of circumstances including cuts, punctures and burns. Most wounds usually heal quickly without complications. However, wounds that are not treated properly can become infected.
Products containing petroleum are often used to treat skin infections. However, this is not an ideal treatment for infected wounds because petroleum can be toxic and inhibit healing. Researchers at the University of Georgia have developed a new treatment that promotes healing without being toxic. The product contains vitamin E, which prevents wounds from dehydrating and encourages healing.
The treatment was originally developed by a UGA professor to treat burns. It works by enhancing the effectiveness of antibiotics, which are often applied topically to wounds to kill or slow the growth of harmful microorganisms, such as bacteria. The UGA researchers are currently seeking a patent for the treatment. It was used successfully last year to treat a burned dog and is currently being used to treat skin ulcers on a beluga whale at the Georgia Aquarium in Atlanta.
“In the case of burn victims, whether animal or human, bacteria and fungi can infect the open wounds and kill the patient,” said Dr. Bran Ritchie, a research scientist at the UGA College of Veterinary Medicine, in a press release. “We have found a way to kill those drug-resistant bacteria and fungi with compounds that cleanse wounds while being gentle on the tissue.”
The development of this product is significant because it could have many human applications, including wounds on swimmers and other athletes.
“In high-school athletics especially, getting staph infections from scratches is a huge problem. Our bioadhesive can adhere to wet skin, cleanse the wound and promote healing” said Richie. The researchers are also hoping to develop a non-oily gel formulation for use as a combination cleanser and ointment for killing acne-causing bacteria.
Details regarding the treatment were released by the University of Georgia in an Apr. 12, 2007 press release.
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Warmer Weather Brings Wheezing, Sneezing
November 10, 2007
SUNDAY, April 16 — April showers bring — the beginning of another allergic asthma season, experts say.
"Allergic asthma is the most common form of asthma," Dr. Sheldon L. Spector, chairman of the American Academy of Allergy, Asthma, and Immunology’s asthma diagnosis committee, said in a prepared statement. "Asthma is considered allergic when symptoms become more intense, perhaps resulting in an asthma attack, when the individual is exposed to allergens to which their immune system is sensitive."
An estimated 20 percent of Americans struggle with allergic asthma; about 60 percent of asthma attacks are caused by allergens, including pollen, animal dander, dust mites, mold, cockroaches and forest-fire smoke, according to the AAAAI.
Allergic and non-allergic asthma have similar symptoms: Coughing, wheezing, shortness of breath or rapid breathing, and chest tightness.
The AAAAI offers the following tips on how to reduce asthma attacks caused by allergens:
- Watch for ozone alerts, which will help keep you aware of the potential triggers for the day.
- Keep your outdoor activities to a minimum when temperatures are especially high.
- Take your asthma medications as prescribed in the recommended doses. Do not take more medication to ease severe symptoms without first consulting your doctor.
- Use an air conditioner in your home and car to keep air clean, cool and dry.
- Don’t stand directly behind cars with their engines on. Exhaust fumes can trigger an asthma attack.
SOURCE: American Academy of Allergy, Asthma and Immunology, news release, April 2007
Experts Push for Rosacea Awareness
November 10, 2007
SATURDAY, April 15 — April is Rosacea Awareness Month, and experts want to alert people to the signs of this facial skin disorder affecting an estimated 14 million Americans.
"Rosacea is frustrating and baffling for so many people because its conspicuous signs and symptoms may not only come and go unexpectedly, but they can affect various individuals in ways few might imagine," Dr. Richard Odom, a professor of dermatology at the University of California, San Francisco, said in a prepared statement.
"Unfortunately, without treatment rosacea tends to become progressively worse — and can have a substantial impact both physically and on people’s emotional, social and professional lives," Odom said.
Rosacea usually first appears between the ages of 30 and 60 and often resembles a sunburn or blush on the cheeks, nose, chin or forehead. It happens again and again, becoming ruddier and lasting longer each time. If the condition isn’t treated, bumps and pimples can develop and grow more extensive over time. Burning, itching and stinging are common. Blood vessels can become visible in the face.
In severe cases, the nose may become enlarged from the development of excess tissue. The eyes are also affected in about 60 percent of people with rosacea. This can lead to vision problems.
"The good news is that, while rosacea cannot be cured, it can be effectively controlled with medical therapy and lifestyle changes," Odom said.
SOURCE: American Academy of Allergy, Asthma and Immunology, news release, April 3, 2007
Fat-seeking laser may treat acne and heart disease
November 10, 2007
Apr 14 - Researchers have found that a laser can be used to heat fat without damaging the overlying skin. Therapies based on these findings could be used for the treatment of many conditions, including acne and atherosclerosis.
Researchers at the Wellman Center for Photomedicine at Massachusetts General Hospital, Harvard Medical School and the Department of Energy’s Thomas Jefferson National Accelerator Facility evaluated the effect of infrared laser light on lipid-rich tissues. The scientists used the Free-Electron Laser located at the Jefferson Lab for the study. The FEL produces intense beams of laser light that can be set to a precise wavelength. FEL beams are also more powerful than beams from a conventional laser.
For the first part of the study, the researchers exposed a range of wavelengths to human fat obtained from surgically discarded healthy tissue. They measured how various wavelengths heated the fat and compared the results to a similar experiment conducted with pure water. They found three wavelengths where fat was more efficiently heated than water - 915, 1210 and 1720 nm.
The researchers then exposed 2-inch samples of fresh, intact pig skin-and-fat tissue to the FEL’s infrared light. The skin was first placed near a cold window to simulate the application of a cold compress prior to laser exposure. The researchers than used the two most promising wavelengths, 1210 and 1720 nm, to zap the pig samples. Beams of light ranging from 8 to 17 millimeters were applied for 16 seconds.
At the end of the study, the researchers found that the 1210 nm wavelength heated pig fat up to 1 cm deep, without damaging the overlying skin. At 1210 nm, laser-induced heating of fat was more than twice that of the overlying skin; at 1720 nm, it was about 1.7 times that of skin.
These findings are significant because they prove that selective photothermolysis can be used safely to treat a number of conditions. The researchers are especially interested in the laser’s potential use in the treatment of acne.
“The root cause of acne is a lipid-rich gland, the sebaceous gland, which sits a few millimeters below the surface of the skin” explained Rox Anderson, lead author of the study and a practicing dermatologist at Harvard, in a press release. “We want to be able to selectively target the sebaceous gland, and this research shows that if we can build lasers at this region of the spectrum, we may be able to do that.”
The researchers also believe that effective laser treatments could emerge for other medical disorders involving lipid-rich tissues, such as atherosclerosis. Atherosclerosis is a disease in which the arteries are hardened and narrowed as a result of plaque that has built up along the inside of the artery walls. A selective treatment that stabilizes lipid plaques could be more effective than previous attempts at laser treatment for heart disease.
Details of the study were released by the Thomas Jefferson National Accelerator Facility in an Apr. 10, 2007 press release.
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Antibiotics May Control Asthma Flare-ups
November 10, 2007
WEDNESDAY, April 12 — Antibiotics may help people who struggle with acute asthma flare-ups.
British researchers found that giving the antibiotic Ketek significantly reduced asthma symptoms in people having a flare-up, which is sometimes called an exacerbation.
But the therapy isn’t ready to become a standard feature of care.
"It’s a little too early to make recommendations for practice," said study lead author Dr. Sebastian Johnston, a professor of respiratory medicine at the National Heart and Lung Institute at Imperial College London. "The findings are very interesting but one would like to see them reproduced in another study. And one would also like to see studies with other related and unrelated antibiotics to see if it’s a particular property of this antibiotic or if it extends to other antibiotics."
Dr. Klaus-Dieter Lessnau, a board-certified lung and critical-care medicine specialist at Lenox Hill Hospital in New York City, added, "It is a nice new treatment option but right now it appears that it’s not so powerful in terms of results. We wish we had more powerful medications to help these patients but it [Ketek] does have some impact. It’s a high-quality study and it’s certainly very well done."
The study was sponsored by Sanofi-Aventis, which makes the drug; Johnston reported receiving consulting fees from the company.
Antibiotics were widely used to treat asthma flare-ups 20 or 30 years ago, when it was thought that bacteria were involved in exacerbations.
"Over the last 10 to 15 years, it’s become clearer that viruses are the main cause, so current treatment guidelines actually recommend that antibiotics not be routinely prescribed," Johnston said. Antibiotics can fight bacteria, but are generally thought to be ineffective against viruses.
But Johnston believes there is increasing evidence that bacterial organisms, specifically Mycoplasma pneumoniae and Chlamydophila pneumoniae, may play a role in asthma flare-ups.
Antibiotics also have anti-inflammatory properties and experts speculate that some may even have antiviral activity.
The researchers chose Ketek for the study because it belongs to a class of antibiotics called ketolides, which are effective in fighting M. pneumoniae and C. pneumoniae.
The drug is approved for the treatment of sinusitis, acute exacerbations of chronic bronchitis and pneumonia.
Asthma is a chronic disease that narrows the airways when they’re exposed to an allergen, such as mold spores, pollen and animal dander. This restricts air flow to the lungs, producing symptoms like coughing, chest tightness, and trouble breathing.
For the new study, which appears in the April 13 issue of the New England Journal of Medicine, 278 adults with diagnosed asthma were enrolled within 24 hours of having an acute exacerbation. The participants were randomly assigned to receive 10 days’ treatment with Ketek or a placebo, in addition to usual care that might include a corticosteroid.
Tests were also done to determine the presence of C. pneumoniae or M. pneumoniae.
At the beginning of the trial, people in the Ketek group gave their symptoms an average score of 3, on a scale of 0 to 7. This score declined to 1.7 by the end of treatment. Those in the placebo group started at 2.8 and declined only to 2.0.
Participants in the Ketek group also experienced improvements in symptom-free days and in four assessments of lung function performed at the clinic. The improvements came faster than in the placebo group.
They did not, however, experience improvement in peak expiratory flow rates, measured at home by the patients themselves.
"Our feeling is that home peak flow recordings were unreliable and that’s why they didn’t give significant results," Johnston said. "In retrospect, that was not a very wise choice [for a primary result] because patients are not trained in any way."
Participants taking Ketek also experienced more nausea but, other than that, side effects were equal between the two groups.
However, several cases of severe liver injury, one of which resulted in death, have been documented among users of Ketek, previous research has found.
Interestingly, while almost two-thirds of the study participants had evidence of infection with C. pneumoniae or M. pneumoniae, there was no relationship between this infection and response to treatment, the researchers said.
It’s possible the drug works by several different mechanisms of action, Johnston said, including anti-inflammatory activity.
"Our study was not large enough to give us enough confidence to be certain about individual mechanisms," he said.
SOURCES: Sebastian L. Johnston M.D., Ph.D., professor of respiratory medicine, National Heart and Lung Institute, Imperial College London, England; Klaus-Dieter Lessnau, M.D., board-certified lung specialist, critical-care medicine specialist and internal medicine specialist, Lenox Hill Hospital, and clinical assistant professor of medicine, New York University School of Medicine, both in New York City; April 13, 2007, New England Journal of Medicine
Work-related eczema leads to unemployment
November 10, 2007
Apr 06 - Severe eczema caused by soaps and other irritants in the workplace may lead to unemployment for some workers, according to new research.
Eczema is an itchy, noncontagious inflammation of the skin. Often used interchangeably with the term “dermatitis,” eczema usually begins as intense itching, followed by a patchy rash that is red, inflamed, dry and scaly. Eczema can be triggered by a number of factors including direct skin contact with various irritants and allergens .
Occupational hand eczema is a form of the condition that occurs when individuals are exposed to soap, chemicals, detergents and other irritants in the workplace. OHE may result in frequent eruptions, impacting quality of life and leading to absenteeism.
In a recent study, researchers from the University of Copenhagen, Hellerup, Denmark were able to identify predictive risk factors for the disease. The researchers studied a group of men and women listed in the Danish National Board of Industrial Injuries Registry as having OHE between Oct. 1, 2001, and Nov. 10, 2002. Each participant received questionnaires focusing on the topics of sick leave, job loss, depression, health-related quality of life and eczema severity. The researchers then sent a follow-up questionnaire a year after the initial questionnaire was returned.
Of the 621 patients who responded to the first questionnaire, 564 completed the follow-up. At the time of follow-up, 25 percent of surveyed patients reported having persistently severe or aggravated OHE, 41 percent had improved and 34 percent of patients reported unchanged minimal or mild to moderate OHE.
After reviewing their data, the researchers found that having a severe case of OHE, being 40 years of age or older and having a low self-rated quality of life predicted unemployment and prolonged sick leave . In addition, patients with a lower socioeconomic status were at high risk for prolonged sick leave, a change of job and unemployment. The research also revealed that the groups most affected by OHE were butchers, kitchen workers and cooks, hairdressers and people between the ages of 25 and 29.
These findings are significant because physicians could use these predictive factors to guide treatment and to select early risk management strategies.
The study appears in the March issue of Archives of Dermatology.
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Gene behind dry skin discovered
November 9, 2007
Mar 27 - Scientists have identified a specific genetic mutation that causes dry skin and predisposes people to eczema and to a lesser extent, asthma.
Dry skin is a common condition that results from a loss of moisture in the skin. It may be accompanied by itching, flaking or the appearance of fine lines. Dry skin often leads to the development of eczema . Past research has also linked severe eczema to asthma, a chronic inflammation of the airway tissues.
Scientists at the University of Dundee have uncovered the gene that causes dry skin and leads to the development of eczema. The gene produces filaggrin, a protein normally found in large amounts in the outer layers of the skin. Filaggrin helps to form a protective layer at the skin’s surface. It is needed to keep water in the skin and keep foreign substances out.
In one study, the researchers found that a reduction or complete lack of filaggrin led to poor formation of the skin barrier. Consequently, people with less than normal or no filaggrin were found to have skin that dries out too easily. The outer layers of skin are also weakly formed, and as a result, constantly flake off.
During a second study, the researchers discovered that filaggrin mutations lessen the skin’s protective barrier, allowing foreign organisms to enter the skin more easily. Once they enter the body, these organisms are recognized by the immune system, which can lead to the development of eczema. In some individuals, this can also lead to asthma when the foreign substances ultimately enter the lungs.
These findings are significant because they may lead to better treatment and prevention methods. Currently, eczema treatments only provide symptom relief. The discovery of the filaggrin gene defect may lead to the development of treatments aimed at the underlying cause of the disorder.
The research appears in the March and April issues of Nature Genetics.
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More minorities seeking plastic surgery
November 9, 2007
Mar 22 - In 2005, more Hispanics, African Americans and Asians had plastic surgery performed, according to new statistics released by the American Society of Plastic Surgeons .
Plastic surgery is a procedure performed to change an external part of the body or its appearance. It may be performed to address problems that result from disease, trauma or congenital defects , or may be completed solely to improve the appearance of the body or skin .
The number of ethnic patients who chose to undergo cosmetic surgery to improve their appearance jumped significantly in 2005, with nearly 2.3 million procedures performed. This was a dramatic increase of 65 percent from 2004.
Among all minority groups, Hispanics remained the group most often seeking cosmetic surgery, with more than 921,000 cosmetic procedures performed . African Americans were the next most common group with 769,000 procedures , followed by Asians who underwent 437,000 procedures .
When statistics for all ethnic groups were evaluated , Hispanics were found to comprise 9 percent of the 10.2 million cosmetic plastic surgery procedures in 2005. They were closely followed by African Americans and Asians with .
The statistics also showed that nose reshaping was the most commonly requested surgical cosmetic procedure among all three groups. The most commonly requested minimally-invasive cosmetic procedures for all three ethnic groups were Botox injections and chemical peel.
These findings are significant because they demonstrate the increasing popularity of plastic surgery among a variety of ethnic groups.
The statistics were released by the American Society of Plastic Surgeons in a Mar. 16, 2007 press release.
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