Efficacy of lasers and light sources in long-term hair reduction: a systematic review.

Laser and light-based devices provide scope for long-term "hair-removal" however, there is limited evidence supporting their long-term efficacy. This study aimed to assess the long-term efficacy of laser and light-based "hair-removal" devices, taking into account variations in body site-specific variations in hair growthcycles. A systematic review of randomized controlled trials (RCTs) with follow-up periods greater than or equal to the length of one complete hair growth cycle in the body site targeted was conducted. Only five eligible RCTs were identified as suitable for inclusion, and these comprised a total of 223 patients. The average long-term hair reduction reported for neodymium:yttrium-aluminum-garnet (Nd:YAG) laser ranged from 30 to 73.61%, Alexandrite laser ranged from 35 to 84.25%, and Diode laser ranged from 32.5 to 69.2%. In all three devices, the greatest long-term reduction was observed from trials targeting leg hair (1-year growth cycle) and lowest from targeting facial hair (6-month growth cycle). Intense pulsed light (IPL) produced average long-term hair reduction of 52.7-27%; smallest reduction was observed from targeting the face area and greatest from targeting the axillary area (7-month growth cycle). In conclusion, greater long-term hair reduction was observed on body sites with longer hair growth cycles. Future trials should take into account the variation of hair growth cycles across body sites to provide accurate long-term data on treatment outcomes.

The role of perioperative endoscopic retrograde cholangiopancreatography and biliary drainage in large liver hydatid cysts.

BACKGROUND: The best surgical technique for large liver hydatid cysts (LHCs) has not yet been agreed on. Objectives. The objective of this study was to examine the role of perioperative endoscopic retrograde cholangiopancreatography (ERCP) and biliary drainage in patients with large LHCs. MetHODS: A 20-year retrospective study of patients with LHCs treated surgically at the University Clinical Center of Kosovo (UCCK). We divided patients into 2 groups based on treatment period: 1981-1990 (Group I) and 2001-2010 (Group II). Demographic characteristics (sex, age), the surgical procedure performed, complications rate, and outcomes were compared. RESULTS: Of the 340 patients in our study, 218 (64.1%) were female with median age of 37 years (range, 17 to 81 years). 71% of patients underwent endocystectomy with partial pericystectomy and omentoplication, 8% total pericystectomy, 18% endocystectomy with capitonnage, and 3% external drainage. In Group I, 10 patients underwent bile duct exploration and T-tube placement; in Group II, 39 patients underwent bile duct exploration and T-tube placement. In addition, 9 patients in Group II underwent perioperative ERCP with papillotomy. The complication rate was 14.32% versus 6.37%, respectively (P = 0.001). CONCLUSION: Perioperative ERCP and biliary drainage significantly decreased the complication rate and improved outcomes in patients with large LHCs.

Iron hypothesis of cardiovascular disease: still controversial.

Iron hypothesis has been a controversial subject for over 30 years as many studies support its role as a risk factor for cardiovascular disease, while other studies found no evidence to support it. The conflicting results are accounted for by the non-homogeneity of trial design in terms of population inclusion criteria and different endpoints, non-uniform use of parameters for assessing iron role, and incomplete understanding of the mechanisms of action. The nature of iron is dual, being of crucial importance for the human body, but also toxic as "free iron" induces oxidative stress. Under physiological conditions, there are efficient and complex mechanisms against iron-induced oxidative stress, which could be reproduced for creating new, intelligent antioxidants. Iron depletion improves the cardiovascular prognosis only if serum concentration is at the lowest limit of normal ranges. However, low iron levels and the type of dietary iron intake correlate with atherosclerotic cardiovascular disease, influence the ischemic endpoints in the elderly, and exert negative impact on heart failure prognosis. So far, the causal relation and involved mechanisms are not fully elucidated. Iron overload is a difficult and frequent condition, involving the cardiovascular system by specific pathogenic pathways, therefore determining a particular form of restrictive cardiomyopathy and vaso-occlusive arterial damage.

[Arrhythmogenic effects of alcohol]. / Efecte aritmogene ale etanolului.

UNLABELLED: Acute or chronic excessive consumption of alcohol can cause cardiac arrhythmias, particularly supraventricular tachyarrhythmias. Experimental and clinical data show that chronic excessive alcohol ingestion has a destructive role on cardiac tissue, which significantly deteriorates the rhythm and contractile activity, manifested by the appearance of cardiac arrythmias and dilated cardiomyopathy. AIM: The aim of this study was to evaluate and analyze the ECG changes and disturbances of cardiac rhythm and conduction in patients after an acute or chronic excessive consumption of alcohol. MATERIAL AND METHODS: The study included 187 patients (184 males and 3 females). Each patient followed biochemical and hematological analysis as well as paraclinical investigation measurements. RESULTS: The most common types of arrhythmia were permanent atrial fibrillation (61%). Paroxysmal atrial fibrillation and supraventricular extrasystoles were found in patients without significant echocardiographic deteriorations. These arrhythmias appeared after an excessive alcohol drinking and paroxysmal atrial fibrillation was converted to normal sinus rhythm after a short period of abstinence or after pharmacologic therapy. Ventricular arrhythmias (ventricular extrasystoles, non-sustained ventricular tachycardia-4.7%, torsada de point-1.5%) were less frequent. Conduction disturbance (left bundle branch-LBBB 6.3%, right bundle branch-RBBB 10%) were found in patients who had a history of consuming >150 g/day of alcohol for >10 years, with dilated heart chambers and systolic ventricular function much more deteriorated (symptomatic stage of heart failure). CONCLUSION: Excessive alcohol consumption may lead to cardiac arrhythmias in patients with existing heart disease as well as in healthy individuals.

A comparison of three single layer anastomotic techniques in the colon of the rat.

INTRODUCTION: Although intestinal anastomoses are mainly made by staplers, manual anastomoses are still in use worldwide. In previous studies, single layer anastomosis has shown better results compared to double layer techniques. PURPOSE: To test experimentally some aspects of three different single layer anastomotic techniques in order to identify advantages and disadvantages of each. MATERIAL AND METHODS: The study was done on Sprague Dawley rats. Animals were randomly divided into four groups. Three experimental groups consisted of 21 animals each, and the fourth sham group contained 10 animals. By 7 animals of each group were sacrificed on the 4th and the rest of 14 animals on the 7th postoperative day. In all groups the resected distal part of the colon was anastomosed using Halsted, Gambee and Gambee-Halsted technique. To evaluate each specific technique the following were used: postoperative complication frequency, biomechanical measurements, adhesion density, condition of intestinal lumen and histological parameters of the healing process. RESULTS: The complication frequency was not significantly different between the tested techniques. The average bursting pressure and tensile strength were higher on both the 4th and 7th postoperative days with the Gambee technique. In the colon segments removed on the 4th postoperative day 97% of pressure induced ruptures occurred in the anastomotic line, whereas on the 7th postoperative day 76% of ruptures occurred about 1cm distal to the anastomotic line. CONCLUSION: The Gambee technique had significantly better biomechanical and histological results compare to the other two anastomotic techniques. Adhesion density was significantly lower in the control group (p<0.001).

Cardiodepressive effects of alcohol.

UNLABELLED: The toxic effect of alcohol on the heart was recognized long time ago. The aim of our study was to evaluate the cardiodepressive effect of alcohol in our in-patients and compare the obtained results with those in the literature. MATERIAL AND METHOD: The study included 187 patients (184 men and 3 women) aged 30 to 75 years and followed-up for 8 years. All patients underwent a series of biochemical and hematological test and paraclinical investigations. RESULTS: Our study demonstrates the toxic effects of alcohol on the contractile function of the myocardium, and the deterioration of the global left-ventricular contractile function in all patients. In all our patients the following were found: enlarged cardiac chambers, increased left ventricular mass, systolic dysfunction (reduced left ventricular ejection fraction and shortening fraction), diffuse left ventricular hypokinesis, normal or thickened wall, and signs and symptoms of heart failure. CONCLUSION: The severity of the clinical symptoms and the results of the performed examinations were directly related to the amount and duration of alcohol consumption.