RESUMEN
Malassezia restricta and Malassezia globosa are lipid dependent commensal yeasts associated with dandruff. Antifungal actives such as zinc pyrithione are commonly used in antidandruff shampoos, although their efficacy is not clearly demonstrated. In this study, we assessed the efficacy of antifungal treatments on scalp Malassezia via a combination of culturomic and genomic detection methods. Zinc pyrithione inhibited Malassezia growth at low minimum inhibitory concentrations (MICs). In a longitudinal pilot study, quantitative polymerase chain reaction (qPCR) analysis showed a decrease in M. restricta on the scalp after zinc pyrithione treatment. These findings validate the antifungal efficacy of zinc pyrithione as a dandruff treatment. LAY ABSTRACT: Malassezia yeasts are associated with dandruff and seborrheic dermatitis. Zinc pyrithione is effective against Malassezia growth in vitro and when tested on human skin as a shampoo. These findings will be useful for investigating the role of Malassezia in skin microbiome intervention studies.
Asunto(s)
Antifúngicos/farmacología , Malassezia/efectos de los fármacos , Malassezia/crecimiento & desarrollo , Compuestos Organometálicos/farmacología , Piridinas/farmacología , Cuero Cabelludo/efectos de los fármacos , Piel/efectos de los fármacos , Simbiosis/efectos de los fármacos , Adulto , Anciano , Estudios de Cohortes , Humanos , Estudios Longitudinales , Malassezia/clasificación , Malassezia/genética , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Proyectos Piloto , Cuero Cabelludo/microbiología , Piel/microbiología , Jabones/química , Jabones/farmacología , Encuestas y Cuestionarios , Adulto JovenRESUMEN
OBJECTIVE: The human scalp harbours a vast community of microbiotal mutualists. Androgenetic alopecia (AGA), the most common form of hair loss in males, is a multifactorial condition involving genetic predisposition and hormonal changes. The role of microflora during hair loss remains to be understood. After having characterized the scalp microbiota of 12 healthy male subjects and 12 AGA male subjects (D0), the aim of this investigation was to evaluate the capacity of Lindera strychnifolia root extract (LsR) to restore a healthy bacterial and fungal scalp microflora after 83 days (D83) of treatment. MATERIAL AND METHODS: The strategy used was based on high-throughput DNA sequencing targeting the encoding 16S ribosomal RNA for bacteria and Internal Transcribed Spacer 1 ribosomal DNA for fungi. RESULTS: Test analysis of relative abundance comparing healthy and AGA subjects showed a significant increase of Cutibacterim acnes (P < 0.05) and Stenotrophomonas geniculata (P < 0.01) in AGA subjects. AGA scalp condition was also associated with a significant (P < 0.05) decrease of Staphylococcus epidermidis relative abundance. A lower proportion of Malassezia genus in samples corresponding to AGA scalps and an increase of other bacterial genera (Wallemia, Eurotium) were also noted. At the species level, mean relative abundance of Malassezia restricta and Malassezia globosa were significantly lower (P < 0.05) in the AGA group. Eighty-three days of treatment induced a significant decrease in the relative abundance of C. acnes (P < 0.05) and S. geniculata (P < 0.01). S. epidermidis increased significantly (P < 0.05). At the same time, LsR treatment induced a significant increase in the proportion of M. restricta and M. globosa (P < 0.05). CONCLUSION: Data from sequencing profiling of the scalp microbiota strongly support a different microbial composition of scalp between control and AGA populations. Findings suggest that LsR extract may be a potential remedy for scalp microbiota re-equilibrium.
OBJECTIF: Le cuir chevelu humain abrite une vaste communauté microbienne. L'alopécie androgénétique (AGA), la forme la plus courante de perte de cheveux chez l'homme, est une pathologie multifactorielle impliquant une prédisposition génétique et des changements hormonaux. Le rôle de la microflore lors de la chute des cheveux reste à comprendre. Après avoir caractérisé le microbiote du cuir chevelu de 12 hommes sans alopecie et 12 hommes porteur d'une alopécie, (J0), l'objectif de cette étude était d'évaluer la capacité de l'extrait de racine de Lindera strychnifolia (LsR) à restaurer une microflore bactérienne et fongique saine du cuir chevelu après 83 jours (D83) de traitement. MATÉRIEL ET MÉTHODES: La stratégie utilisée était basée sur un séquençage d'ADN à haut débit ciblant l'ARN ribosomal 16S codant pour les bactéries et l'ADN ribosomal de l'espaceur transcrit interne 1 pour les champignons. RÉSULTATS: Une augmentation significative de Cutibacterim acnes (P < 0,05) et Stenotrophomonas geniculata (P < 0,01) chez les sujets AGA a ete note a J0 comparativement aux sujets non alopecique. L'état du cuir chevelu AGA était également associé à une diminution significative (P < 0,05) de l'abondance relative de Staphylococcus epidermidis. Une plus faible proportion du genre Malassezia dans les échantillons correspondant aux cuirs chevelus AGA et une augmentation d'autres genres bactériens (Wallemia, Eurotium) ont également été notées. Au niveau des espèces, l'abondance relative moyenne de Malassezia restricta et Malassezia globosa était significativement plus faible (P < 0,05) dans le groupe AGA. Quatre-vingt-trois jours de traitement ont induit une diminution significative de l'abondance relative de C. acnes (P < 0,05) et S. geniculata (P < 0,01). S. epidermidis a augmenté de manière significative (P < 0,05). Dans le même temps, le traitement LsR a induit une augmentation significative de la proportion de M. restricta et M. globosa (P < 0,05). CONCLUSION: Les données de séquençage soutiennent fortement une composition microbienne différente du cuir chevelu entre les populations témoin et AGA. Les résultats suggèrent que l'extrait de LsR peut être un remède potentiel pour le rééquilibre du microbiote du cuir chevelu.
Asunto(s)
Alopecia/microbiología , Lindera/química , Microbiota , Extractos Vegetales/farmacología , Raíces de Plantas/química , Cuero Cabelludo/efectos de los fármacos , Alopecia/tratamiento farmacológico , Bacterias/clasificación , Bacterias/aislamiento & purificación , Hongos/clasificación , Hongos/aislamiento & purificación , Humanos , Masculino , Persona de Mediana Edad , Extractos Vegetales/uso terapéuticoRESUMEN
The Trapa japonica fruit is a natural plant growing in ponds with its roots in the mud. It has long been used as a home remedy for many diseases; however, a major problem with this kind of natural extract is the multicomponents-multitargets for diseases. Such problems make it difficult to identify the mechanism of action. Another problem is quality control and consistency. The aim of this research was to isolate a single bioactive compound (peptide) derived from the Trapa japonica fruit. The research was conducted with various experimental techniques, such as fermentation and liquid chromatography, to isolate a peptide. We isolated the AC 2 peptide from Trapa japonica fruit and found it to be promising on human dermal papilla cells. Dihydrotestosterone (DHT) stresses human dermal papilla cells and is a major cause of hair loss resulting from hormones and environmental factors. The purpose of this research was to develop an understanding of the mechanism by which the AC 2 peptide rescues dihydrotestosterone (DHT)-treated human dermal papilla cells. We explored the effects of the AC 2 peptide on the cell biological functions of human dermal papilla cells (HDPs). HDPs were treated with the AC 2 peptide and DHT. Then, a cytotoxicity assay, flow cytometry, Western blot, immunoprecipitation, and 3D cell culture for immunohistochemistry were conducted to investigate the mTORC1 pathway and suppression of autophagy and apoptosis. In addition, we also synthesized the AC2 peptide as an alternative to the expensive and difficult isolation and purification procedures and confirmed its potential in biomedical applications. We also validated the effects of the synthetic AC2 peptide as well as the isolated and purified AC2 peptide and established their similarity. Although extensive research has been carried out on natural extracts, few single studies have isolated and separated a bioactive peptide (single compound).
Asunto(s)
Apoptosis/efectos de los fármacos , Autofagia/efectos de los fármacos , Bacillus/fisiología , Dihidrotestosterona/farmacología , Folículo Piloso/efectos de los fármacos , Lythraceae/química , Extractos Vegetales/farmacología , Alopecia/metabolismo , Alopecia/patología , Alopecia/prevención & control , Células Cultivadas , Citoprotección/efectos de los fármacos , Dermis/citología , Dermis/efectos de los fármacos , Dermis/metabolismo , Frutas/química , Folículo Piloso/citología , Folículo Piloso/metabolismo , Humanos , Lythraceae/microbiología , Diana Mecanicista del Complejo 1 de la Rapamicina/metabolismo , Fragmentos de Péptidos/química , Fragmentos de Péptidos/farmacología , Extractos Vegetales/química , Cuero Cabelludo/citología , Cuero Cabelludo/efectos de los fármacos , Transducción de Señal/efectos de los fármacosRESUMEN
BACKGROUND: The purpose of this study was to compare the effects of scalp nerve block (SNB) and local anesthetic infiltration (LA) with 0.75% ropivacaine on postoperative inflammatory response, intraoperative hemodynamic response, and postoperative pain control in patients undergoing craniotomy. METHODS: Fifty-seven patients were admitted for elective craniotomy for surgical clipping of a cerebral aneurysm. They were randomly divided into three groups: Group S (SNB with 15 mL of 0.75% ropivacaine), group I (LA with 15 mL of 0.75% ropivacaine) and group C (that only received routine intravenous analgesia). Pro-inflammatory cytokine levels in plasma for 72 h postoperatively, hemodynamic response to skin incision, and postoperative pain intensity were measured. RESULTS: The SNB with 0.75% ropivacaine not only decreased IL-6 levels in plasma 6 h after craniotomy but also decreased plasma CRP levels and increased plasma IL-10 levels 12 and 24 h after surgery compared to LA and routine analgesia. There were significant increases in mean arterial pressure 2 and 5 mins after the incision and during dura opening in Groups I and C compared with Group S. Group S had lower postoperative pain intensity, longer duration before the first dose of oxycodone, less consumption of oxycodone and lower incidence of PONV through 48 h postoperatively than Groups I and C. CONCLUSION: Preoperative SNB attenuated inflammatory response to craniotomy for cerebral aneurysms, blunted the hemodynamic response to scalp incision, and controlled postoperative pain better than LA or routine analgesia. TRIAL REGISTRATION: Clinicaltrials.gov NCT03073889 (PI:Xi Yang; date of registration:08/03/2017).
Asunto(s)
Anestesia Local/métodos , Anestésicos Locales/administración & dosificación , Craneotomía/tendencias , Aneurisma Intracraneal/cirugía , Bloqueo Nervioso/métodos , Dolor Postoperatorio/prevención & control , Anestésicos Locales/metabolismo , Craneotomía/efectos adversos , Femenino , Hemodinámica/efectos de los fármacos , Hemodinámica/fisiología , Humanos , Mediadores de Inflamación/antagonistas & inhibidores , Mediadores de Inflamación/sangre , Aneurisma Intracraneal/sangre , Masculino , Persona de Mediana Edad , Manejo del Dolor/métodos , Manejo del Dolor/tendencias , Dolor Postoperatorio/sangre , Cuero Cabelludo/efectos de los fármacos , Cuero Cabelludo/inervación , Cuero Cabelludo/metabolismo , Resultado del TratamientoRESUMEN
Shampoo is a hair care product designed to clean the skin and hair of the scalp. Among the ingredients that go into the making of a shampoo are detergents, conditioners, thickeners, sequestering agents, pH adjusters, preservatives, and active ingredients such as anti-dandruff agents. The purpose of this study was to identify the composition of 140 shampoos available in pharmacies, in stores of a mass-market chain, or from mail-order retailers. Forty-one shampoos were advertised as "gentle", 12 as specially formulated for infants, 35 as anti-dandruff, and 52 without any particular claim. We analysed the cleansing base, preservatives, and anti-dandruff agents when relevant and identified the allergens regardless of whether or not they are listed under Regulation (EC) No. 1223/2009 as one of the 26 regulated substances. We discovered that unlike shampoos sold in stores of a mass-market chain and those available from mail-order retailers, those sold in pharmacies expose users to some of the 26 substances listed under Regulation (EC) No. 1223/2009. We also determined that baby shampoos sold in pharmacies are allergen-free. Regarding anti-dandruff formulations, the largest variety of active ingredients was found in shampoos sold in pharmacies. Overall, the most common active ingredients were olamines, zinc pyrithione, azoles, selenium disulphide, and plant extracts. Shampoos sold in pharmacies appear to contain fewer allergens listed under Regulation (EC) No. 1223/2009 compared to those sold elsewhere.
Asunto(s)
Fármacos Dermatológicos/química , Detergentes/química , Preparaciones para el Cabello/química , Cabello/efectos de los fármacos , Humanos , Cuero Cabelludo/efectos de los fármacosRESUMEN
PURPOSE: Scalp cooling as a method to reduce the incidence of chemotherapy-induced alopecia (CIA) is increasingly used in daily practice worldwide. However, in patients treated with 5-fluorouracil, epirubicin and cyclophosphamide (FEC), scalp cooling fails in 48-67% of patients. This study investigated the efficacy of extended duration of post-infusion scalp cooling in breast cancer patients treated with this regimen. METHODS: In this prospective multi-centre randomised study, 102 patients with early breast cancer treated with adjuvant FEC chemotherapy were randomly assigned in a 1:1 ratio to a post-infusion cooling time of 90 or 150 min. The primary endpoint was the need to wear a wig or other head covering to mask visible hair loss. RESULTS: Sixteen out of 48 patients (33%) treated with 90 min of post-infusion cooling did not need any head covering, compared with 21 out of 46 patients (45%) treated with 150 min of post-infusion cooling (p = 0.2). WHO grades 2-3 (moderate-complete) alopecia were reported more often in patients treated with 90-min post-infusion cooling time (n = 25/51 (49%) versus n = 17/51 (33%); p = 0,02). Scalp cooling was well-tolerated (mean Visual Analogue Score 7.4) and only three patients (3%) stopped due to intolerance during treatment. CONCLUSIONS: Extending the duration of 90-min post-infusion scalp cooling to 150 min in patients treated with adjuvant FEC chemotherapy was well-tolerated but did not significantly diminish the need for head covering. However, grades 2-3 alopecia was seen less often with prolonged post-infusion scalp cooling.
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Alopecia/inducido químicamente , Alopecia/prevención & control , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Neoplasias de la Mama/tratamiento farmacológico , Hipotermia Inducida/métodos , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Quimioterapia Adyuvante , Ciclofosfamida/administración & dosificación , Ciclofosfamida/efectos adversos , Epirrubicina/administración & dosificación , Epirrubicina/efectos adversos , Femenino , Fluorouracilo/administración & dosificación , Fluorouracilo/efectos adversos , Humanos , Quimioterapia de Inducción , Persona de Mediana Edad , Cuidados Paliativos/métodos , Estudios Prospectivos , Cuero Cabelludo/efectos de los fármacos , Cuero Cabelludo/fisiopatología , Taxoides/efectos adversosRESUMEN
OBJECTIVES: The most painful stages of craniotomy are the placement of the pin head holder and the skin incision. The primary aim of the present study is to compare the effects of the scalp block and the local anesthetic infiltration with bupivacaine 0.5% on the hemodynamic response during the pin head holder application and the skin incision in infratentorial craniotomies. The secondary aims are the effects on pain scores and morphine consumption during the postoperative 24h. METHODS: This prospective, randomized and placebo controlled study included forty seven patients (ASA I, II and III). The scalp block was performed in the Group S, the local anesthetic infiltration was performed in the Group I and the control group (Group C) only received remifentanil as an analgesic during the intraoperative period. The hemodynamic response to the pin head holder application and the skin incision, as well as postoperative pain intensity, cumulative morphine consumption and opioid related side effects were compared. RESULTS: The scalp block reduced the hemodynamic response to the pin head holder application and the skin incision in infratentorial craniotomies. The local anesthetic infiltration reduced the hemodynamic response to the skin incision. As well as both scalp block and local anesthetic infiltration reduced the cumulative morphine consumption in postoperative 24h. Moreover, the pain intensity was lower after scalp block in the early postoperative period. CONCLUSION: The scalp block may provide better analgesia in infratentorial craniotomies than local anesthetic infiltration.
Asunto(s)
Analgésicos Opioides/uso terapéutico , Anestesia Local/normas , Anestésicos Locales/farmacología , Bupivacaína/farmacología , Craneotomía/normas , Hemodinámica/efectos de los fármacos , Morfina/uso terapéutico , Bloqueo Nervioso/normas , Evaluación de Resultado en la Atención de Salud , Dolor Postoperatorio/diagnóstico , Cuero Cabelludo/inervación , Adulto , Anestesia Local/métodos , Anestésicos Locales/administración & dosificación , Bupivacaína/administración & dosificación , Craneotomía/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Bloqueo Nervioso/métodos , Dolor Postoperatorio/tratamiento farmacológico , Cuero Cabelludo/efectos de los fármacos , Cuero Cabelludo/cirugíaRESUMEN
BACKGROUND: Precision medicine approaches are ideally suited for rare tumors where comprehensive characterization may have diagnostic, prognostic, and therapeutic value. We describe the clinical case and molecular characterization of an adolescent with metastatic poorly differentiated carcinoma (PDC). Given the rarity and poor prognosis associated with PDC in children, we utilized genomic analysis and preclinical models to validate oncogenic drivers and identify molecular vulnerabilities. METHODS: We utilized whole exome sequencing (WES) and transcriptome analysis to identify germline and somatic alterations in the patient's tumor. In silico and in vitro studies were used to determine the functional consequences of genomic alterations. Primary tumor was used to generate a patient-derived xenograft (PDX) model, which was used for in vivo assessment of predicted therapeutic options. RESULTS: WES revealed a novel germline frameshift variant (p.E1554fs) in APC, establishing a diagnosis of Gardner syndrome, along with a somatic nonsense (p.R790*) APC mutation in the tumor. Somatic mutations in TP53, MAX, BRAF, ROS1, and RPTOR were also identified and transcriptome and immunohistochemical analyses suggested hyperactivation of the Wnt/ß-catenin and AKT/mTOR pathways. In silico and biochemical assays demonstrated that the MAX p.R60Q and BRAF p.K483E mutations were activating mutations, whereas the ROS1 and RPTOR mutations were of lower utility for therapeutic targeting. Utilizing a patient-specific PDX model, we demonstrated in vivo activity of mTOR inhibition with temsirolimus and partial response to inhibition of MEK. CONCLUSIONS: This clinical case illustrates the depth of investigation necessary to fully characterize the functional significance of the breadth of alterations identified through genomic analysis.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma/tratamiento farmacológico , Carcinoma/genética , Genómica/métodos , Enfermedades Raras/tratamiento farmacológico , Enfermedades Raras/genética , Adolescente , Animales , Carboplatino/efectos adversos , Carcinoma/diagnóstico por imagen , Análisis Mutacional de ADN , Etopósido/efectos adversos , Resultado Fatal , Humanos , Masculino , Ratones Endogámicos NOD , Ratones Noqueados , Ratones SCID , Paclitaxel/efectos adversos , Enfermedades Raras/diagnóstico por imagen , Cuero Cabelludo/efectos de los fármacos , Cuero Cabelludo/metabolismo , Cuero Cabelludo/patología , Ensayos Antitumor por Modelo de XenoinjertoRESUMEN
BACKGROUND: Mixtures of various local anesthetics, such as lidocaine and ropivacaine, have been widely used. However, their efficacy and safety for scalp nerve blocks and local infiltration during awake craniotomy have not been fully elucidated. METHODS: We prospectively investigated 53 patients who underwent awake craniotomy. Scalp block was performed for the blockade of the supraorbital, supratrochlear, zygomaticotemporal, auriculotemporal, greater occipital, and lesser occipital nerves with a mixture containing equal volumes of 2% lidocaine and 0.75% ropivacaine, including 5 µg/mL of epinephrine. Infiltration anesthesia was applied at the site of skin incision using the same mixture. The study outcomes included changes in heart rate and blood pressure after head pinning and skin incision, and incidence of severe pain on emergence from anesthesia. Total doses and plasma concentrations of lidocaine and ropivacaine were measured at different time points after performing the block. RESULTS: The heart rate and blood pressure after head pinning were marginally, but significantly, increased when compared with baseline values. There were no significant differences in heart rate and blood pressure before and after the skin incision. Nineteen percent of the patients (10/53) complained of incisional pain at emergence from anesthesia. The highest observed blood concentrations of lidocaine and ropivacaine were 1.9±0.9 and 1.1±0.4 µg/mL, respectively. No acute anesthetic toxicity symptom was observed. CONCLUSIONS: Scalp block with a mixture of lidocaine and ropivacaine seems to provide effective and safe anesthetic management in patients undergoing awake craniotomy.
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Amidas , Anestesia Local/métodos , Anestésicos Locales , Craneotomía , Lidocaína , Bloqueo Nervioso/métodos , Presión Sanguínea/efectos de los fármacos , Quimioterapia Combinada , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Ropivacaína , Cuero Cabelludo/efectos de los fármacos , Cuero Cabelludo/cirugía , Resultado del Tratamiento , VigiliaRESUMEN
BACKGROUND: To evaluate efficacy and cost-effectiveness of a plant-derived wound dressing (ONE), a mixture of hypericum oil (Hypericum perforatum L.) and neem oil (Azadirachta indica A. Juss.), in scalp wounds with exposed bone. PATIENTS AND METHODS: All patients with scalp wounds with exposed bone, following the excision of skin tumors, and treated with ONE in 2011 were included. Time of healing, wound size, area of exposed bone, ease of handling, pain, and complications were evaluated. Costs of dressings and nursing time were compared with those cited in literature for other treatment modalities. RESULTS: Fifteen consecutive patients with a mean age of 76.87 ± 10.3 years (59-90 years) were analyzed. The mean wound size was 10.9 ± 6.84 cm(2) (0.4-22.6 cm(2)) with 4.8 ± 5.9 cm(2) (0.3-20.7 cm(2)) of exposed bone. The time of complete healing by secondary intention was 8.1 (4-20) weeks. Rapid formation of granulation tissue was observed which after 4 weeks covered the entire exposed bone surface in 11 of 15 cases (73%). Dressing change was simple with no pain reported; no infections or other complications occurred. Using ONE for a mean healing time of 56.7 days resulted in mean costs of EUR 423.73, which is substantially lower than those published for fascia lata, negative pressure therapy, or collagen matrix followed by skin grafting (EUR 1,612.82, EUR 4,411.80 and EUR 1,503.72, respectively). CONCLUSION: This retrospective, non-controlled analysis supports ONE as a simple-to-use and safe treatment option for scalp wounds with exposed bone. Treatment costs compare favorably to those published for other treatment modalities.
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Vendajes , Glicéridos/uso terapéutico , Hypericum , Fitoterapia/economía , Fitoterapia/métodos , Extractos Vegetales/economía , Extractos Vegetales/uso terapéutico , Cuero Cabelludo/efectos de los fármacos , Cuero Cabelludo/cirugía , Neoplasias Cutáneas/cirugía , Terpenos/uso terapéutico , Cicatrización de Heridas/efectos de los fármacos , Anciano , Anciano de 80 o más Años , Análisis Costo-Beneficio , Combinación de Medicamentos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , SuizaRESUMEN
BACKGROUND: Rapid skin warming and prompt correct medical treatment lead to dramatic improvement in patients with peripheral capillary-related damage, such as injuries, Raynaud disease and frostbite. AIM: To characterize a novel composite, NXCL-4950, for use in a cosmetic lotion. METHODS: The effects of NXCL-4950 on enhancing skin blood flow, skin temperature warming, and expansion of peripheral blood vessels and scalp microvessels were investigated. RESULTS: Monitoring by laser Doppler perfusion imaging and thermal imaging showed that application of NXCL-4950 to the hands increased skin blood flow and temperature relative to the control (or placebo) group. For the 20 participants with a high Raynaud Condition Score, application of NXCL-4950 to the skin resulted in a mean increase of 215.53% in microvessel diameter and mean increase of 164.96% in the speed of blood flow. When NXCL-4950 was applied to the scalp, the microvessels around the hair roots were clearly visible after 20 min. CONCLUSION: NXCL-4950 is a potential candidate for enhancing peripheral skin temperature, and might be useful in the treatment of capillary-related disorders.
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Mezclas Complejas/uso terapéutico , Enfermedades Vasculares Periféricas/tratamiento farmacológico , Extractos Vegetales/uso terapéutico , Flujo Sanguíneo Regional/efectos de los fármacos , Enfermedades de la Piel/tratamiento farmacológico , Temperatura Cutánea/efectos de los fármacos , Vasodilatadores/uso terapéutico , Administración Tópica , Adulto , Femenino , Humanos , Flujometría por Láser-Doppler , Masculino , Microvasos/efectos de los fármacos , Cuero Cabelludo/efectos de los fármacos , Piel/irrigación sanguínea , Adulto JovenRESUMEN
OBJECTIVE: To explore an effective therapy for children of early cerebral palsy. METHODS: One hundred and twenty cases were randomly divided into an acupoint injection group and a medication group, 60 cases in each group. The acupoint injection group was treated with scalp point injection of 0.5-1 mL brain protein hydrolysate into each point, Baihui (GV 20), Fengchi (GB 20) and motor area etc. were selected; the medication group was treated with 10 mL brain protein hydrolysate by intravenous drip. The therapeutic effects in the two groups were observed, and the changes of cerebral blood flow were compared before and after treatment. RESULTS: The total effective rate of 91.4% in the acupoint injection group was superior to that of 73.7% in the medication group (P<0.05), the acupoint injection group could significantly improve the systolic peak velocity (Vs), end diastolic velocity (Ved) and mean velocity (Vm) of middle cerebral artery (MCA) and anterior cerebral artery (ACA), and decrease the vascular resistance index (RI) (all P<0.05), and the improvement degree was superior to the medication group (all P<0.05). CONCLUSION: Scalp point injection therapy can significantly improve the cerebral microcirculation of patients, and has a good therapeutic effect for early cerebral palsy.
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Puntos de Acupuntura , Parálisis Cerebral/tratamiento farmacológico , Circulación Cerebrovascular/efectos de los fármacos , Medicamentos Herbarios Chinos/administración & dosificación , Hidrolisados de Proteína/uso terapéutico , Cuero Cabelludo/efectos de los fármacos , Parálisis Cerebral/fisiopatología , Niño , Femenino , Humanos , Inyecciones , Masculino , Cuero Cabelludo/irrigación sanguínea , Cuero Cabelludo/fisiopatologíaRESUMEN
BACKGROUND: The issue of postoperative pain after neurosurgery is controversial. It has been reported as mild to moderate and its treatment may be inadequate. Infiltration of the surgical site with local anesthetics has provided transient benefit after craniotomy, but its effect on chronic pain has not been evaluated. Accordingly, we designed the present study to test the hypothesis that ropivacaine infiltration of the scalp reduces acute and persistent postoperative pain after intracranial tumor resection. METHODS: This was a prospective, single-blinded study. Inclusion criteria were intracranial tumor resection, age > or = 18 or < or = 80 yr, and ability to understand and use a visual analog scale (VAS). Exclusion criteria were history of craniotomy, chronic drug abuse, and neurologic disorders. All eligible patients were randomly included in Group I (infiltration) or C (control). Postoperative analgesia was IV acetaminophen combined with nalbuphine. At the end of the surgery, Group I received an infiltration of the surgical site with 20 mL of ropivacaine 0.75%. Acute pain was evaluated hourly by VAS during the first 24 h. The analgesic effect of ropivacaine was evaluated based on total consumption of nalbuphine and VAS scores. The incidence of persistent pain and neuropathic pain was assessed at the 2-mo postoperative evaluation. We used the Student's t-test to compare total nalbuphine consumption, repeated measures analysis of variance with post hoc Bonferroni t-test for VAS score and the Fisher's exact test for chronic and neuropathic pain. RESULTS: Fifty-two patients were enrolled, 25 in Group I and 27 in Group C. Demographic and intraoperative data were similar between groups. Group I showed a nonsignificant trend toward reduced nalbuphine consumption during the first postoperative day, 11.2 +/- 9.2 mg vs 16.6 +/- 11.0 mg for Group C (mean +/- SD, P = 0.054). VAS scores were significantly higher in Group C. Two months after surgery, persistent pain was significantly lower in Group I, 2/24 (8%) vs 14/25 (56%), P = 0.0003. One patient (4.1%) in Group I versus six (25%) patients in Group C (P = 0.04) experienced neuropathic pain. CONCLUSIONS: Because pain is moderate after intracranial tumor resection, there is limited interest in scalp infiltrations with ropivacaine in the acute postoperative period. Nevertheless, these infiltrations may be relevant for the rehabilitation of neurosurgical patients and their quality of life by limiting the development of persistent pain and particularly neuropathic pain.
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Amidas/administración & dosificación , Anestesia Local/métodos , Neoplasias Encefálicas/tratamiento farmacológico , Neoplasias Encefálicas/cirugía , Dolor Postoperatorio/prevención & control , Cuero Cabelludo/efectos de los fármacos , Adulto , Anciano , Analgesia/métodos , Neoplasias Encefálicas/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor/efectos de los fármacos , Dolor Postoperatorio/fisiopatología , Estudios Prospectivos , Ropivacaína , Cuero Cabelludo/fisiología , Método Simple CiegoRESUMEN
Procyanidin B-2 is a compound we have identified in apple which acts as a growth-promoting factor on murine hair epithelial cells. This report describes our investigation of the hair-growing effects of 1% procyanidin B-2 tonic after sequential use for 4 months. A double-blind clinical trial was performed, involving a total of 29 subjects (procyanidin B-2, 19 men; placebo, 10 men). No adverse side effects were observed in either group. In the procyanidin B-2 group, 78.9% showed an increased mean value of hair diameter, whereas only 30.0% in the placebo group showed any increase (p < 0.02, Fisher's exact probability test). The increased ratio of hairs measuring more than 40 microm in diameter after 4 months of procyanidin B-2 treatment was significantly higher than that of the placebo controls (p < 0.05, two-sample-t-test). The increase in number of total hairs in the designated scalp area (0.25 cm(2)) of procyanidin B-2 subjects after a 4 month trial was significantly greater than that of the placebo controls (procyanidin-B-2, 3.67 +/- 4.09 (mean +/- SD)/0.25 cm(2); placebo, -2.54 +/- 4.00/0.25 cm(2); p < 0.001, two-sample t-test). Procyanidin B-2 therapy shows potential as a promising cure for male pattern baldness.
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Alopecia/prevención & control , Biflavonoides , Catequina/farmacología , Catequina/uso terapéutico , Cabello/crecimiento & desarrollo , Proantocianidinas , Administración Cutánea , Adulto , Catequina/administración & dosificación , Cabello/efectos de los fármacos , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Cuero Cabelludo/efectos de los fármacosAsunto(s)
Antiinflamatorios/uso terapéutico , Valerato de Betametasona/uso terapéutico , Psoriasis/terapia , Dermatosis del Cuero Cabelludo/terapia , Terapia Ultravioleta , Administración Tópica , Glucocorticoides , Humanos , Cuero Cabelludo/efectos de los fármacos , Cuero Cabelludo/patología , Cuero Cabelludo/efectos de la radiación , Resultado del TratamientoRESUMEN
The insecticidal effect was tested of a shampoo with 0.33% of pyrethrum extract and a shampoo with 1% malathion. The study was carried out in 222 patients and better results were observed with the pyrethrum shampoo which required only one application.
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Chrysanthemum cinerariifolium , Preparaciones para el Cabello/administración & dosificación , Infestaciones por Piojos/tratamiento farmacológico , Malatión/administración & dosificación , Extractos Vegetales/administración & dosificación , Adulto , Niño , Femenino , Humanos , Masculino , Cuero Cabelludo/efectos de los fármacosRESUMEN
Nine healthy men with type IVa or Va male pattern baldness completed a 4-month single-blinded controlled pilot study designed to assess the effect of ultraviolet light (UVL) on topical minoxidil-induced hair growth. Subjects applied 2% topical minoxidil solution twice daily to their balding scalps and to one target area on the upper arm. These men, all of whom had either skin type II or III, were randomized to also receive either incremental doses of UVB or PUVA (topical psoralen) twice weekly to one side of their scalp and to a 2.5 cm target area on the nonminoxidil-treated upper ipsilateral arm. Vellus, nonvellus, and total hair counts were done in two 1-inch in diameter circular target areas in symmetric regions of the scalp and on each upper arm at regular intervals. All nine subjects had an increase in target nonvellus hair and a net loss of vellus hair in scalp target area treated with topical minoxidil. Concomitant UVL did not have a significant synergistic nor adverse effect on topical minoxidil-induced hair growth.
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Alopecia/radioterapia , Minoxidil/uso terapéutico , Terapia Ultravioleta/métodos , Adulto , Alopecia/tratamiento farmacológico , Enfermedad Crónica , Ensayos Clínicos como Asunto , Terapia Combinada , Humanos , Masculino , Minoxidil/efectos adversos , Terapia PUVA/efectos adversos , Distribución Aleatoria , Cuero Cabelludo/efectos de los fármacos , Cuero Cabelludo/efectos de la radiación , Terapia Ultravioleta/efectos adversosAsunto(s)
Alopecia/tratamiento farmacológico , Minoxidil/administración & dosificación , Pirimidinas/administración & dosificación , Vasodilatadores/administración & dosificación , Administración Tópica , Alopecia/metabolismo , Animales , Biopsia , Método Doble Ciego , Evaluación de Medicamentos , Evaluación Preclínica de Medicamentos , Femenino , Humanos , Masculino , Minoxidil/metabolismo , Minoxidil/farmacología , Ratas , Flujo Sanguíneo Regional/efectos de los fármacos , Cuero Cabelludo/irrigación sanguínea , Cuero Cabelludo/efectos de los fármacos , Cuero Cabelludo/patología , Absorción CutáneaRESUMEN
A total of 199 patients were selected for a comparison of the anti-dandruff efficacy of four shampoos. After a 2-week lead in (all patients used only Johnson's Baby Shampoo twice weekly) the patients were randomly assigned to Selsun Blue, Head & Shoulders, Flex, or Tegrin. The test preparation, which was unknown to the observer, was used twice weekly for 4 weeks. Loose and adherent dandruff were each rated on a scale of 0 to 20 (absent to severe) at the end of the lead-in (when a total score of 15 was required), and each week of study. The mean total pre-study score for all subjects was 19.5. At the end of the study the mean improvement scores were: 16.2 (Selsun Blue), 14.6 (head & Shoulders), 13.5 (Flex), and 13.1 (Tegrin). The improvement was significantly greater (p less than 0.05) on Selsun Blue than on any of the other shampoo. At the end of the study significantly (p less than 0.05) more patients had total scores of zero on Selsun Blue (15) than on Tegrin or Head & Shoulders. In addition, the rate of improvement was significantly (p less than 0.05) faster with Selsun Blue than with any of the other test preparations.