To decrease morbidity and mortality from melanoma, it is imperative to identify patients who are at high risk for developing widespread disease. Gene expression profiling (GEP) technology may impact melanoma management as physicians are better equipped to measure prognosis. Many different GEP signatures have been investigated. We searched Pubmed, Cochrane CENTRAL, and Embase for studies on GEP in primary melanoma prognosis and assessed GEP signatures for prognostic and analytic validity and clinical impact. The relationship between GEP and survival was measured using hazard ratios (HR) and odds ratios (OR). We found twenty-nine articles comprising 9 gene signatures meeting inclusion criteria and conducted a meta-analysis on 6 studies on a 31-gene signature. High-risk GEP status was associated with poorer recurrence-free survival (HR=7.22; 95% CI, 4.75-10.98), distant metastasis-free survival (HR=6.62; 95% CI, 4.91-8.91), and overall survival (HR=7.06; 95% CI, 4.44-11.22); as well as sentinel lymph node biopsy positivity (OR=2.99; 95% CI, 2.15-4.15). With recent improvements in treating advanced melanoma, accurately assessing prognosis is important. This study has clinical implications for melanoma patients who may benefit from prognostic testing. These results may be useful to clinicians when ordering GEP testing and help them make better management decisions.
The results suggest that observers store contextual information gained from longer viewing durations to aid in the perception of distance at brief glimpses, and that this memory becomes more important with age.
Background: Polypodium leucotomos extract (PLE) is a naturally derived compound from a fern native to South America. PLE has been shown to have antioxidant and photoprotective properties. Several different preparations of PLE are commercially available.Objective: To review the efficacy and safety of PLE for photoprotection in humans.Methods: A systematic review was conducted in 3 databases (Medline, Embase, and Cochrane) for studies that reported on the clinical efficacy and safety of PLE in humans. A data collection form was created for collecting study variables and risk of bias was assessed.Results: Eighteen studies with sample sizes ranging from n=5 to n-61 were included. The most common formulation of PLE studied was Fernblock® (Heliocare, Ferndale Healthcare, Ferndale, MI) in 18 studies. Most studies reported beneficial photoprotective effects of PLE as evidenced by increased MED. No serious adverse effects were reported.Conclusions: Multiple studies have shown the beneficial photoprotective effects and safety of the Fernblock® PLE formulation, but there is minimal evidence to support the safety and efficacy of other formulations. Given that the extraction methodology varies for herbal nutraceuticals and can affect its efficacy, these findings cannot be extrapolated to other formulations of PLE.
Whole body cryotherapy (WBC) is a medical treatment utilizing sub-freezing temperatures to enhance recovery after exercise and facilitate injury rehabilitation. Recently the therapy has been advocated to help skin appear and feel healthier, fight age-related deficiencies, and increase antioxidant production. The currently available evidence appears to be insufficient to support the use of WBC for improving skin and there is some small potential for risk. There are no well-controlled studies evaluating the clinical effects of WBC on the skin. Although there is selected data to support possible theories for WBC's purported skin rejuvenation effects, the evidence at this time remains limited. Further investigation may be warranted to determine if WBC can actually have a proven beneficial effect on skin.
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