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1.
J Cosmet Dermatol ; 19(1): 241-245, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31020789

RESUMO

BACKGROUND: Striae gravidarum (SG) can cause pregnant women severe psychological stress. OBJECTIVE: This study aimed to compare primigravidas with and without SG concerning fasting blood coenzyme Q10 (CoQ10), age, skin type, family history, gestational weight gain, pre- and post-pregnancy BMI, daily water consumption during pregnancy, gender and weight of baby, and the educational level. METHODS: The study included 79 primigravidas in the gestational week of 36 or above. The patients were divided into two groups based on the presence of SG. The fasting blood CoQ10 levels and other associated parameters were compared between the groups. RESULTS: Of the 79 primigravidas, 35 (44.3%) had SG. There was no statistically significant relationship between striae and CoQ10 (P = 0.144 and P = 0.189, respectively). Predisposing factors for striae were young pregnancy, light skin color, family history, high pre- and post-pregnancy BMI, increased gestational weight gain, and increased newborn weight. There was no significant relationship between striae development and educational level or water consumption during pregnancy. CONCLUSION: This is the first study to show that CoQ10 did not significantly differ between women with and without SG. Further studies with a larger case series are needed to elucidate predisposing factors for striae and involvement of CoQ10 in this condition.


Assuntos
Complicações na Gravidez/epidemiologia , Estrias de Distensão/epidemiologia , Ubiquinona/análogos & derivados , Adulto , Fatores Etários , Peso ao Nascer/fisiologia , Feminino , Ganho de Peso na Gestação/fisiologia , Número de Gestações , Humanos , Recém-Nascido , Idade Materna , Anamnese , Gravidez , Complicações na Gravidez/sangue , Complicações na Gravidez/diagnóstico , Terceiro Trimestre da Gravidez/sangue , Fatores de Risco , Pigmentação da Pele/fisiologia , Estrias de Distensão/sangue , Estrias de Distensão/diagnóstico , Ubiquinona/sangue , Circunferência da Cintura/fisiologia , Adulto Jovem
2.
Trials ; 19(1): 553, 2018 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-30314504

RESUMO

BACKGROUND: Striae gravidarum (stretch marks) are considered the most common connective tissue/skin change in pregnancy. Though not a health issue they can affect women in different ways, for example, cause stress or be an aesthetic or cosmetic concern. Many women use one or more of the commercially available products to try and prevent their development during pregnancy despite the fact that that there is a lack of high-quality evidence to support their use. There is a dearth of studies on the prevention of striae gravidarum and large, robust trials are lacking. Until such time as more products are investigated, much of the knowledge remains anecdotal. This pilot study will evaluate the feasibility of conducting a study to evaluate the effectiveness of a commercially available moisturising oil compared to no treatment for the prevention and reduction in severity of striae gravidarum. METHODS: The definitive study will be a randomised controlled trial to evaluate the effectiveness of a moisturising oil (commercially available moisturising oil) compared to no treatment for the prevention and reduction in severity of striae gravidarum. This protocol is for a pilot randomised trial to evaluate the feasibility of conducting such a study. The pilot study will be a two-arm, unblinded, pragmatic parallel randomised trial with a 1:1 randomisation ratio between control and intervention groups. Women in the intervention group will be asked to apply a moisturising oil to their abdomen during pregnancy, while women in the control group will not use any treatment. It is proposed to recruit 20 primigravida, who are 12-16 weeks pregnant from an Irish Maternity Hospital, in each arm to assess the feasibility of running such a trial. DISCUSSION: This pilot trial will evaluate the feasibility of conducting the main study to evaluate the effectiveness of a moisturising oil (commercially available moisturising oil) compared to no treatment for the prevention and reduction in severity of striae gravidarum. It will potentially initiate the generation of high-quality evidence to guide women in their choice of anti-stretch mark product. TRIAL REGISTRATION: ISRCTN Registry, ISRCTN76992326 . Registered on 14 July 2017.


Assuntos
Emolientes/administração & dosagem , Complicações na Gravidez/prevenção & controle , Pele/efeitos dos fármacos , Estrias de Distensão/prevenção & controle , Administração Cutânea , Emolientes/efeitos adversos , Estudos de Viabilidade , Feminino , Humanos , Irlanda , Projetos Piloto , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Índice de Gravidade de Doença , Pele/patologia , Estrias de Distensão/diagnóstico , Estrias de Distensão/etiologia , Fatores de Tempo , Resultado do Tratamento
4.
Aesthet Surg J ; 38(9): 990-997, 2018 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-29596639

RESUMO

Background: Stretch marks are common permanent dermal lesions that can cause psychosocial distress. A number of treatment modalities are available, with the majority targeted towards collagen production. Objectives: To develop and field test a new BODY-Q scale to measure appearance of stretch marks in order to provide a means to incorporate the patient perspective into future treatment studies. Methods: We previously described the development of the BODY-Q conceptual framework, which involved a literature review, 63 patient interviews, 22 cognitive interviews and input from 9 experts, and the international field-test study that involved 403 weight loss and 331 body contouring patients. To develop the Stretch Marks scale, we reexamined appearance codes from the original interviews. The scale was field tested in an international study. Rasch measurement theory (RMT) analysis was used to refine the scale and examine measurement properties. Results: The Stretch Marks scale was completed by 630 participants, who provided 774 assessments. After dropping 3 items, the data fit the Rasch model (P = 0.56). Items (eg, length, width, amount, location, up close) mapped out a well-targeted clinical hierarchy. All items had ordered thresholds and good item fit. There was no evidence of differential item functioning (bias) by gender, age group or language (English vs Danish). The scale evidenced high reliability (ie, person separation index = 0.94, Cronbach's alpha = 0.97). For construct validity, the mean score correlated with the total number of body areas with stretch marks, higher BMI before bariatric surgery, and other BODY-Q scales. Conclusions: This scale could be used to measure the impact of innovative treatments for stretch marks.


Assuntos
Contorno Corporal/métodos , Avaliação de Resultados da Assistência ao Paciente , Estrias de Distensão/diagnóstico , Inquéritos e Questionários , Adulto , Idoso , Cirurgia Bariátrica/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/cirurgia , Satisfação do Paciente , Psicometria , Pesquisa Qualitativa , Reprodutibilidade dos Testes , Estrias de Distensão/etiologia , Estrias de Distensão/psicologia , Estrias de Distensão/terapia , Perda de Peso , Adulto Jovem
5.
Lasers Med Sci ; 33(3): 609-617, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29308552

RESUMO

This research work mainly deals with studying qualitatively the changes in the dermal collagen of two forms of striae distensae (SD) namely striae rubrae (SR) and striae albae (SA) when compared to normal skin (NS) using confocal Raman spectroscopy. The methodology includes an in vivo human skin study for the comparison of confocal Raman spectra of dermis region of SR, SA, and NS by supervised multivariate analysis using partial least squares discriminant analysis (PLS-DA) to determine qualitatively the changes in dermal collagen. These groups are further analyzed for the extent of hydration of dermal collagen by studying the changes in the water content bound to it. PLS-DA score plot showed good separation of the confocal Raman spectra of dermis region into SR, SA, and NS data groups. Further analysis using loading plot and S-plot indicated the participation of various components of dermal collagen in the separation of these groups. Bound water content analysis showed that the extent of hydration of collagen is more in SD when compared to NS. Based on the results obtained, this study confirms the active involvement of dermal collagen in the formation of SD. It also emphasizes the need to study quantitatively the role of these various biochemical changes in the dermal collagen responsible for the variance between SR, SA, and NS.


Assuntos
Colágeno/metabolismo , Derme/metabolismo , Análise Espectral Raman/métodos , Estrias de Distensão/diagnóstico , Estrias de Distensão/metabolismo , Adulto , Análise Discriminante , Feminino , Humanos , Análise dos Mínimos Quadrados , Água/metabolismo
6.
Pediatr Dermatol ; 35(1): 59-63, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29159996

RESUMO

BACKGROUND: This study examines the clinical characteristics and demographics of teenage boys with horizontal striae distensae of the lower back in an outpatient setting. METHODS: Retrospective medical chart reviews and telephone survey studies were completed on an outpatient cohort of 12 boys 11 to 17 years of age with a clinical diagnosis of transverse striae distensae of the lower back at a single-center, university-based, pediatric dermatology practice. We evaluated the clinical features of the striae, participant demographic characteristics, and past medical history. A review of the literature concerning risk factors was conducted using PubMed and Google Scholar. RESULTS: Of the 14 patients we contacted, 12 agreed to participate. The average age of onset for the striae was 14.3 years. All boys were above the 50th percentile in height at the time of onset. Eight (66.7%) reported a significant growth spurt before the appearance of the stretch marks. Most were asymptomatic. None of the boys had a history of unmonitored exogenous steroid use or prior infection with Bartonella henselae or Borrelia burgdorferi. Only one (8.3%) had a chronic medical condition. Eleven (91.7%) had at least one first-degree relative with striae distensae. CONCLUSION: Our results indicate that horizontal striae distensae of the lower back in adolescent boys is associated with a rapid growth spurt, tall stature, and family history of striae distensae. There is no association between this type of striae distensae and any chronic medical condition, bacterial infection, or exogenous steroid use. Thus a careful review of systems and counseling without further medical testing is reasonable management.


Assuntos
Estrias de Distensão/diagnóstico , Adolescente , Dorso/patologia , Criança , Demografia , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Estrias de Distensão/epidemiologia
14.
Aesthet Surg J ; 34(7): 1050-8, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25056910

RESUMO

BACKGROUND: Breast augmentation is the most popular cosmetic surgery procedure in the United States. Postoperative striae is a known but incompletely understood complication of breast augmentation. OBJECTIVES: The authors investigated their own patient population to discern risk factors for new-onset striae after cosmetic breast augmentation. METHODS: A retrospective chart review was performed for patients who underwent primary breast augmentation from 2005 to 2012 in a single-surgeon practice. Initial chart review revealed that only patients aged ≤25 years exhibited new striae; therefore, only patients from this age group were included. Potential risk factors examined included age, body mass index (BMI), oral contraceptive use, time of last menstrual period (LMP), parity, smoking and alcohol status, diabetes mellitus, and personal history of striae. Implant and surgical factors examined included implant material (silicone vs saline), volume, and location (submuscular vs subglandular placement) and the site of incision. RESULTS: Of the 549 patients included in the study, 17 (3.10%) had new-onset striae, observed at a mean of 58 days postoperatively. The risk of striae was statistically significantly higher (P<.05) among patients who were younger (3.3 times), were nulliparous (14.38 times), began their LMP>14 days before surgery (9.24 times), and had a history of striae (6.11 times). There was a strong correlation between new-onset breast striae and implant size, as well as BMI (P=.07). CONCLUSIONS: There is a strong correlation between new-onset striae and hormone levels, genetic factors, and tissue stretch components in patients who undergo cosmetic breast augmentation. This information can be utilized to better educate patients about this potential complication. LEVEL OF EVIDENCE: 4.


Assuntos
Implante Mamário/efeitos adversos , Estrias de Distensão/etiologia , Adolescente , Adulto , Fatores Etários , Implante Mamário/instrumentação , Implantes de Mama , Feminino , Humanos , Desenho de Prótese , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Estrias de Distensão/diagnóstico , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
15.
Pediatr Dermatol ; 31(5): 617-8, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-23072309

RESUMO

Striae distensae or stretch marks are a common skin condition that occurs frequently in association with adolescent growth spurts and pregnancy. They are characterized by linear symmetrical asymptomatic smooth bands of atrophic-appearing skin on the thighs, buttocks, and breasts in girls and on the shoulders, outer thighs, and lumbosacral areas in boys. We present a rare case of unilateral striae distensae affecting the right axilla in a 16-year-old boy.


Assuntos
Axila , Estrias de Distensão/diagnóstico , Adolescente , Humanos , Masculino
16.
BMJ Case Rep ; 20132013 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-24351515

RESUMO

A 14-year-old boy was referred to a paediatric clinic after a recent diagnosis of coeliac disease, which was well controlled on a gluten-free diet. During the consultation, the mother raised concerns regarding marks that had developed over her son's back over the past 6 months. On examination, a number of horizontal, coloured bruise-like marks were noted over the lower back. The appearance was suspicious of bruising and possible non-accidental injury, although a history of trauma or injury was denied. Blood tests including a coagulation screen were arranged which were normal and the patient was followed up twice during a 6-month period. He remained well but the bruising was persistent. It was concluded that these were striae associated with pubertal growth. This case summarises the importance of careful surveillance of bruising in children and illustrates the association between striae and pubertal growth which may be confused with non-accidental injury.


Assuntos
Dorso , Contusões/diagnóstico , Crescimento , Puberdade , Estrias de Distensão/diagnóstico , Adolescente , Humanos , Masculino , Estrias de Distensão/etiologia
17.
Arch Dermatol Res ; 305(7): 603-17, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23579949

RESUMO

Striae distensae (SD) are cutaneous lesions often presenting post-pregnancy with atrophy and flattening of the epidermis. SD is poorly understood and treatment remains ill-defined. Our aim was to assess the effect of topical application of silicone gel compared with placebo on SD using non-invasive devices and by immunohistochemical analysis of sequential tissue biopsies in a double-blind controlled trial. Twenty volunteers massaged silicone and placebo gels into separate sides of the abdomen, daily for 6 weeks. Objective non-invasive imaging plus subjective self-assessment of SD were performed on days 0, 21, 42, 90, in addition to tissue biopsies on days 0 and 42. Non-invasive imaging demonstrated an increase in melanin and a decrease in haemoglobin, collagen and pliability over the 6-week period on both sides. Additionally, collagen levels in SD were significantly higher (p value = 0.001) and melanin levels lower (p value = 0.048) with silicone gel compared with placebo. Histological analysis revealed epidermal flattening with a reduction of rete ridges in SD on both sides. Vascular count significantly decreased with placebo gel (p = 0.002). Corroborating the clinical results, melanin levels increased, whilst collagen type 1 and elastin decreased on both sides. Non-invasive techniques showed that the application of silicone gel increased collagen levels and reduced pigmentation compared with placebo. However, both clinical and histological data revealed that melanin increased whilst collagen, elastin and pliability decreased over the 6-week period with both gels. Furthermore, vascularity significantly decreased with placebo gel. These findings provide preliminary evidence of the utility of topical gels in the clinical management of SD.


Assuntos
Géis/uso terapêutico , Pele/efeitos dos fármacos , Estrias de Distensão/tratamento farmacológico , Administração Tópica , Adolescente , Adulto , Colágeno/metabolismo , Diagnóstico por Imagem , Método Duplo-Cego , Elastina/metabolismo , Feminino , Humanos , Imuno-Histoquímica , Masculino , Melaninas/metabolismo , Pessoa de Meia-Idade , Pele/patologia , Espectrofotometria , Estrias de Distensão/diagnóstico , Adulto Jovem
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