Hair restoration approaches for early onset male androgenetic alopecia.

Society places great emphasis on the presence of hair. Some degree of hair loss is accepted as a normal part of the aging process, in line with the observation that more than 50% of men will develop androgenetic alopecia by the age of 50 years. However, it is possible to understand the psychosocial isolation and distress felt by men with a strong familial predisposition to androgenetic alopecia, who tend to display hair loss in their late teens or twenties. There are currently two drugs which have been licensed for the treatment of male androgenetic alopecia: oral finasteride and topical minoxidil solution which are effective to some extent. Furthermore, upon discontinuing treatment, any gain that has been achieved is quickly lost. Added to which there is an entire market of unproven over the counter products: advertised in the electronic media, local hair salons, and various departmental stores. In this review, we highlight the important advances in the management of male androgenetic alopecia with emphasis on approaches that can lead to more successful and long-term hair restoration for young adults. In particular, we discuss the evidence supporting the use of the follicular unit grafting technique in conjunction with medical treatment before and after the procedure. Moreover, some other alterations of this most popular state of the art hair restoration technique have been mentioned briefly. As a result, patients and physicians seem equally satisfied from this procedure for its naturally looking results which are cosmetically more acceptable and esthetically pleasing for longer period of time.

Diagnostic yield of EBUS-TBNA for the evaluation of centrally located peribronchial pulmonary lesions.

BACKGROUND: The purpose of this study was to evaluate the diagnostic yield of endobronchial ultrasound with real-time-guided transbronchial needle aspiration (EBUS-TBNA), endobronchial forceps biopsy (EBBx), and 2D fluoroscopic-guided transbronchial forceps biopsy (TBLBx) for centrally located peribronchial lung lesions. METHODS: A retrospective chart review of consecutive patients who underwent EBUS-TBNA of centrally located peribronchial lesions, that is, medial margin of the mass within inner third of hemithorax by computerized tomography scan. Patients who underwent EBUS-TBNA for lymph node sampling were excluded. RESULTS: Thirty-two cases met the inclusion criteria. The mean age was 69±12 years. Sixteen (50%) were male patients. Of the 32 EBUS-TBNA cases, 13 underwent concomitant TBLBx (group 1), 8 had concomitant EBBx (group 2), and 11 had EBUS-TBNA alone (group 3). In group 1, the diagnostic yield of EBUS-TBNA was 95% (n=12/13), whereas the yield of TBLBx was 61% (n=8/13). In group 2, the diagnostic yield of EBUS-TBNA was 100% (n=8/8), whereas EBBx was positive in 75% (n=6/8). In group 3, the diagnostic yield of EBUS-TBNA was 91% (n=10/11). Overall diagnostic yield of EBUS-TBNA of centrally located peribronchial lung lesions was 94% (n=30/32). CONCLUSION: Where available, EBUS-TBNA of centrally located peribronchial lung lesions should be given a strong consideration given its high diagnostic yield.