Retrospective cohort study of prenatally and postnatally diagnosed coarctation of the aorta (CoA): prenatal diagnosis improve neonatal outcome in severe CoA.

Introduction: Prenatal diagnosis of congenital heart disease (CHD) leads to improved outcome but not mortality rate. This may not be the case for coarctation of the aorta (CoA). The objective of this study is to estimate the effect of a prenatal diagnosis of CoA by comparing neonates with CoA by the time of diagnosis.Materials and methods: The study included 38 neonates with CoA diagnosed prenatally and 102 neonates diagnosed postnatally. The postnatal group was divided into two subgroups: (1) severe CoA: symptoms of CoA within the first 7 days (n = 43) and (2) mild CoA: symptoms within the 8-28th day (n = 34). The neonates diagnosed more than 28 days after delivery were excluded from the study (n = 25). Severe CoA was defined as CHD diagnosed postnatally with clinical symptoms that presented in the first week after birth. Mild CoA was defined as CHD that presented clinical symptoms later than 7 days of life.Results: Prostaglandins were initiated at lower doses (p < .001) in the prenatal group. Severe postnatal CoA was associated with more frequent Neonatal Intensive Care Unit (NICU) visits than mild postnatal CoA (p = .005). The length of hospitalization of neonates with severe postnatal CoA was 10 days longer than compared to the prenatal group, but the difference was not statistically significant. The highest mortality rate was in the severe postnatal CoA group (18.6%) which was significantly higher than the mortality rate in the prenatal group (p = .005).Conclusion: 1. Prenatal identification of fetuses at increased risk of developing CoA may reduce mortality and improve outcome only in neonates with severe CoA (symptoms of CoA within the first 7 days after birth); 2. Prenatal diagnosis of severe CoA was associated with lower prostaglandin doses and lower mortality rate.

Intense pulsed light (IPL) treatment for the skin in the eye area - clinical and cutometric analysis.

OBJECTIVE: The aim of the research was to establish the influence of IPL treatment on skin ageing in the eye area. MATERIAL AND METHODS: This study included 24 women, aged 38-63 years (mean age was 48.04) with Fitzpatrick skin type II and III who underwent five successive treatment sessions with an IPL in two-week intervals. The Cutometer (Courage + Khazaka electronic) reference test was an objective method for the assessment of the biomechanical properties of the skin. The measurements were made in three places around the eye. The photo documentation was used to compare state of skin before and after three months of treatments. Additionally, patients filled in a questionnaire, which contained questions concerning self-assessment of the procedure effects. RESULTS: Cutometric analysis showed significant improvement of skin elasticity (statistical significance level is mostly < 0.0001). The comparison of clinical changes in the therapy, based on photo documentation, showed a 25% improvement. CONCLUSIONS: This treatment was used in order to improve skin elasticity and decrease the amount and depth of wrinkles. It is a non-invasive treatment, with low risk of complications.

Nonablative radiofrequency treatment for the skin in the eye area - clinical and cutometrical analysis.

OBJECTIVE: The purpose of the research was to evaluate skin elasticity and reduction in the aging eye area after using a nonablative radiofrequency treatment. MATERIAL AND METHODS: This study included 23 patients, aged 34-58 years with Fitzpatrick skin type II and III. They received five treatment sessions with a nonablative radiofrequency in 1-week intervals. Biomechanical properties of the skin were measured using Cutometer. A photodocumentation was used to compare changes before and after the series of treatment sessions. Additionally, the patients filled in a questionnaire in which they were asked to make a self-evaluation of the procedure. RESULTS: Cutometrical analysis showed improvement of skin elasticity. Changes in the measurements of R2 and R6 parameters indicate that the statistical significance level is mostly P < 0.0001 for the differences in the measurements. The comparison of clinical changes in the therapy, based on photodocumentation, showed a 33.26% improvement. CONCLUSIONS: This treatment was used to improve skin tightness and decrease the amount and depth of wrinkles. It is a noninvasive treatment, with low risk of complications. The cutometrical measurements seem to be useful to assess improvement of elasticity of the skin after cosmetology or esthetic dermatology treatments.

Nonablative fractional laser treatment for the skin in the eye area - clinical and cutometric analysis.

OBJECTIVE: The purpose of the research was to evaluate skin elasticity and reduction in the aging eye area using a 1410-nm nonablative fractional laser treatment, cutometric measurements and photographic documentation. MATERIAL AND METHODS: This study included 24 patients (21 women, three men), aged 33-50 years (the average age was 44.6) with Fitzpatrick skin type II and III. They received five successive treatment sessions with a 1410-nm nonablative fractional laser in 2-week intervals. Biomechanical properties of the skin were measured by using Cutometer (Courage+Khazaka electronic). Measurements of skin elasticity were made in three places of the eye area. A photographic documentation was used to compare changes after the series of treatment sessions. Additionally, the patients filled in a survey in which they were asked to make a self-evaluation of the administered procedure. RESULTS: Cutometric analysis showed a significant improvement of skin elasticity. Changes in the measurements of R2 and R6 parameters indicate that the statistical significance level is mostly P < 0.0001 for the differences in the measurements. The analysis of clinical results of the therapy, using photographic documentation, showed a 47% decrease in the quantity and depth of wrinkles in the eye area. CONCLUSIONS: A 1410-nm nonablative fractional laser treatment seems to be an effective method aiming at reducing wrinkles in the eye area and improving tightness. Cutometric measurements provide invaluable help in the objective evaluation of the anti-aging treatment and the photographic documentation is an excellent addition to the clinical analysis.

Fractional non-ablative laser treatment at 1410 nm wavelength for periorbital wrinkles - reviscometrical and clinical evaluation.

OBJECTIVE: The aim of the research was to establish the influence of 1410-nm fractional non-ablative laser treatment on skin aging in the eye area. The reviscometer reference test is an objective method of estimating the flexibility of the skin. The photographic records were used as the auxiliary method of the therapy quality effectiveness. MATERIALS AND METHODS: The study involved the group of 13 people (12 females and 1 male, aged 33-47 with prototype II and III according to the Fitzpatrick scale), who underwent two sessions of fractional non-ablative laser therapy (wavelength of 1410 nm) with a 2-week interval. In order to evaluate the effectiveness of the quality of the treatment a reviscometer probe was used to measure the skin elasticity (Reviscometer RVM 600). The measurements were taken twice: directly before and two weeks after the treatment. Furthermore, to facilitate the clinical evaluation an anonymous photographical documentation was prepared. RESULTS: An improvement of the skin flexibility in the eye area was observed and the fact was confirmed by values obtained using the reviscometer probe (significant statistic differences: P < 0.0001) as well as clinical assessment based on photographical records. CONCLUSION: On the basis of the reviscometer measurements analysis and photographical records, 1410-nm fractional non-ablative laser treatment appears to be an efficient method contributing to the improvement of the skin flexibility of the eyes area as well as to the reduction of the number of wrinkles. The post-treatment observation proves that the method is well-tolerated in the sensitive eyes area and does not cause any significant side effects.

Variable pulsed light treatment of melasma and post-inflammatory hyperpigmentation - a pilot study.

Hyperpigmentation disorders are a serious aesthetic problem. Various therapies are applied to remove these lesions. The variable pulsed light (VPL) is similar to intense pulsed light (IPL), but instead of one flash of light, energy is provided in a few small and rapid micro-flashes. The aim of the study is a mexametric evaluation of results of the treatment of hyperpigmentation with the application of the VPL device as well as the patient's opinion on this kind of treatment. The therapy with the VPL was administered twice within a period of three weeks. In order to evaluate the effectiveness of the treatment procedure, we carried out the mexametric measurements three times. Eighteen women with hyperpigmentation disorders were included in the study. The lesions were lightened in thirteen patients. Three patients demonstrated more intensive hyperpigmentation. Twelve patients assessed the effects of the therapy as good and excellent. In the patients, in whom the initial mexametric results confirmed the strongest changes, the effect of the VPL therapy appeared to be the greatest. The obtained results allow claiming that the VPL method is effective for treating hyperpigmentation. The level of the patients' satisfaction after the therapy is equally important.