This study suggests that dynamic cooling can dramatically diminish pain during PWS treatment with the 585-nm PDL without reducing treatment efficacy. The absence of epidermal damage in most patients suggests that precooling with the DCD may allow the use of higher laser fluences to expedite clearance without inducing epidermal change. Dynamic cooling has potential use with other lasers and different lesions where discomfort and epidermal effects limit therapy.
These preliminary results suggest the PDL may eradicate respiratory papillomas with minimal damage to normal laryngeal tissue. Further analysis of the ongoing study is required to demonstrate potential benefits of the technique.
Recent regional and insurance database studies indicate that diagnoses of hidradenitis suppurativa (HS) are rare, with fewer than 200,000 affected patients in the United States. These findings are at odds with the generally accepted prevalence of approximately 1%. To estimate the number of patients diagnosed with HS, including patients enrolled in public health plans and the uninsured, we performed an investigation using National Center for Health Statistics databases of visits to health care providers. Survey data from physician offices and clinics, hospital outpatient departments, and emergency departments in the United States were analyzed. There were 254,000 (95% confidence interval: 180,000, 328,000) health care visits by patients with HS per year from 2002 to 2010. An annualized estimate of 118,000 (95% confidence interval: 83,000, 152,000) patients with HS diagnoses was determined. Excluding emergency department data, the annualized estimate was 100,000 (95% confidence interval: 67,000, 134,000) patients. Adults between 18 and 64 years of age comprised 92.8% (standard error, 2.6%) of HS patients. Of that working-age population, 31.5% (standard error, 5.6%) were enrolled in Medicare or Medicaid, which is a significantly higher proportion than for those in the same age group in the general population. A review of earlier surveys of HS prevalence was performed. HS is a rarely diagnosed disease, and epidemiologic data to support undiagnosed HS as a common disease are lacking.
Patients treated with PDL experienced regression of their papillomas. PDL may provide patients with RRP with an alternative treatment without the risks associated with CO(2) laser surgery. This procedure also has potential to be delivered on an outpatient basis with flexible fiberoptic laryngoscopes.
The independent associations between liver fat, visceral adipose tissue (AT), and metabolic risk factors are unclear. Although it has been reported that visceral AT is the strongest predictor of metabolic risk, liver fat has also been reported as a strong independent associate of a deleterious metabolic profile. We examined the independent associations between liver fat, visceral AT, and metabolic risk factors in a sample of 293 men varying widely in adiposity. Liver fat and abdominal AT were measured by computed tomography (CT). Univariate analysis revealed that liver fat was associated (p < 0.05) with triglycerides (TG), systolic blood pressure (SBP), and total cholesterol (TC), but not with glucose or high-density lipoprotein cholesterol (HDLC). Liver fat remained a significant correlate (p < 0.05) of TG and TC after control for age and subcutaneous AT or cardiorespiratory fitness (CRF), but not after adjustment for visceral AT alone. Conversely, visceral AT remained significantly associated with TG, SBP, glucose, HDLC (p < 0.01), and TC (p = 0.05) independent of liver fat, subcutaneous AT, CRF, and age. Both liver fat and visceral AT were associated with metabolic risk in men. However, when controlled for each other, visceral AT was the only independent associate of metabolic risk.
Laser-induced fluorescence (LIF) of tissues depends on their biochemical and histomorphologic characteristics. LIF spectroscopic properties of 9,10-dimethyl-1,2-benzanthracene (DMBA)-induced precancerous and early cancerous lesions in a hamster buccal pouch mucosa model were studied. Fluorescence spectra from neoplastic lesions showed a characteristic fluorescence peak in the red region of the visible spectrum centered between 630 and 640 nm when excited with 410-nm light. Using this as a diagnostic criterion, 45 of 49 lesions studied were correctly diagnosed, including early dysplastic lesions. Follow-up study of four dysplastic lesions over 2 weeks revealed an increase in red fluorescence intensity. The findings of these experiments suggest that LIF spectroscopy may be a valuable noninvasive technique not only for early diagnosis of head and neck cancer, but also to probe a possible biochemical surrogate biomarker in the follow-up of suspected lesions.
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