Assuntos
Alopecia , Minoxidil , Humanos , Adolescente , Estudos Retrospectivos , Alopecia/tratamento farmacológico , Administração OralRESUMO
Topical minoxidil has been used for many years to treat adult alopecia, and there is growing evidence supporting the off-label use of low-dose oral minoxidil (LDOM). However, there is little data on its use in pediatrics, and there are no recommended treatment guidelines. Adverse events are of particular concern in this population. We retrospectively reviewed the medical records of 63 patients aged between 0 and 12 years from a specialist hair clinic who were treated with LDOM or sublingual minoxidil (SM) to evaluate its safety and tolerability. LDOM and SM were generally well-tolerated, with mild hypertrichosis being the most commonly reported adverse event. Further large-scale studies are warranted to determine the efficacy and optimum dosage of systemic minoxidil for alopecia in the pediatric population.
Assuntos
Alopecia , Minoxidil , Adulto , Humanos , Criança , Recém-Nascido , Lactente , Pré-Escolar , Minoxidil/uso terapêutico , Estudos Retrospectivos , Alopecia/tratamento farmacológico , Alopecia/induzido quimicamente , Cabelo , Administração Tópica , Resultado do TratamentoRESUMO
BACKGROUND: The major concern regarding the use of low-dose oral minoxidil (LDOM) for the treatment of hair loss is the potential risk of systemic adverse effects. OBJECTIVE: To describe the safety of LDOM for the treatment of hair loss in a large cohort of patients. METHODS: Retrospective multicenter study of patients treated with LDOM for at least 3 months for any type of alopecia. RESULTS: A total of 1404 patients (943 women [67.2%] and 461 men [32.8%]) with a mean age of 43 years (range 8-86) were included. The dose of LDOM was titrated in 1065 patients, allowing the analysis of 2469 different cases. The most frequent adverse effect was hypertrichosis (15.1%), which led to treatment withdrawal in 14 patients (0.5%). Systemic adverse effects included lightheadedness (1.7%), fluid retention (1.3%), tachycardia (0.9%), headache (0.4%), periorbital edema (0.3%), and insomnia (0.2%), leading to drug discontinuation in 29 patients (1.2%). No life-threatening adverse effects were observed. LIMITATIONS: Retrospective design and lack of a control group. CONCLUSION: LDOM has a good safety profile as a treatment for hair loss. Systemic adverse effects were infrequent and only 1.7% of patients discontinued treatment owing to adverse effects.
Assuntos
Alopecia/tratamento farmacológico , Minoxidil/efeitos adversos , Administração Oral , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Tontura/induzido quimicamente , Tontura/epidemiologia , Edema/induzido quimicamente , Edema/epidemiologia , Feminino , Cefaleia/induzido quimicamente , Cefaleia/epidemiologia , Humanos , Hipertricose/induzido quimicamente , Hipertricose/epidemiologia , Masculino , Pessoa de Meia-Idade , Minoxidil/administração & dosagem , Estudos Retrospectivos , Distúrbios do Início e da Manutenção do Sono/induzido quimicamente , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Taquicardia/induzido quimicamente , Taquicardia/epidemiologia , Adulto JovemAssuntos
Alopecia/classificação , Adolescente , Adulto , Criança , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Adulto JovemAssuntos
Alopecia em Áreas/tratamento farmacológico , Piperidinas/administração & dosagem , Inibidores de Proteínas Quinases/administração & dosagem , Pirimidinas/administração & dosagem , Pirróis/administração & dosagem , Administração Oral , Adulto , Idoso , Bochecha , Queixo , Humanos , Janus Quinases/antagonistas & inibidores , Masculino , Pessoa de Meia-Idade , Piperidinas/efeitos adversos , Inibidores de Proteínas Quinases/efeitos adversos , Pirimidinas/efeitos adversos , Pirróis/efeitos adversos , Estudos Retrospectivos , Couro Cabeludo , Resultado do Tratamento , Adulto JovemAssuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Doenças do Pênis/tratamento farmacológico , Polimialgia Reumática/tratamento farmacológico , Pioderma Gangrenoso/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Pênis/complicações , Doenças do Pênis/diagnóstico , Polimialgia Reumática/complicações , Polimialgia Reumática/diagnóstico , Pioderma Gangrenoso/complicações , Pioderma Gangrenoso/diagnósticoRESUMO
This article provides the reader with a comprehensive review of high-level evidence-based medicine in facial trauma and highlights areas devoid of high-level evidence. The article is organized in the order one might approach a clinical problem: starting with the workup, followed by treatment considerations, operative decisions, and postoperative treatments. Individual injuries are discussed within each section, with an overview of the available high-level clinical evidence. This article not only provides a quick reference for the facial traumatologist, but also allows the reader to identify areas that lack high-level evidence, perhaps motivating future endeavors.
Assuntos
Medicina Baseada em Evidências , Ossos Faciais/lesões , Traumatismos Faciais/cirurgia , Fraturas Cranianas/cirurgia , Antibioticoprofilaxia , Redução Fechada , Humanos , Redução AbertaRESUMO
Craniofacial fractures and bony defects are common causes of morbidity and contribute to increasing health care costs. Successful regeneration of bone requires the concomitant processes of osteogenesis and neovascularization. Current methods of repair and reconstruction include rigid fixation, grafting, and free tissue transfer. However, these methods carry innate complications, including plate extrusion, nonunion, graft/flap failure, and donor site morbidity. Recent research efforts have focused on using stem cells and synthetic scaffolds to heal critical-sized bone defects similar to those sustained from traumatic injury or ablative oncologic surgery. Growth factors can be used to augment both osteogenesis and neovascularization across these defects. Many different growth factor delivery techniques and scaffold compositions have been explored yet none have emerged as the universally accepted standard. In this review, we will discuss the recent literature regarding the use of stem cells, growth factors, and synthetic scaffolds as alternative methods of craniofacial fracture repair.