The role of platelet-rich plasma in androgenetic alopecia: A systematic review.

BACKGROUND: Androgenetic alopecia (AGA), also referred to as male or female pattern hair loss, is the commonest cause of chronic hair loss and affects up to 80% of men by the age of 70. Despite a high prevalence, there are few approved therapies, which show minimal efficacy. OBJECTIVES: This systematic review aims to evaluate the efficacy of platelet-rich plasma (PrP) in the treatment of AGA in male patients. METHODS: MEDLINE, EMBASE, Cochrane (CENTRAL), CINAHL, clinicaltrials.gov, Google Scholar and the Science Citation Index database were searched to identify eligible studies. All randomized controlled trials (RCTs) and prospective cohort studies related to PrP use in AGA were included. Primary outcomes included changes in hair density and hair count. Methodological quality was assessed using bias assessment tools. RESULTS: Eight RCTs and one cohort study were included in the review with a total of 291 participants. Six studies reported a statistically significant increase in hair density in the PrP group versus the control. Five studies reported a statistically significant increase in hair count with PrP. Seven studies showed moderate risk and two showed low risk of bias. CONCLUSION: In a methodologically robust review on the effectiveness of PrP on male AGA, PrP demonstrated some potential to be used therapeutically. However, the low quality of evidence, moderate risk of bias, and high heterogeneity of included studies limit inferences and call for more robust designs to investigate this further.

Immunization with 60 kD Ro peptide produces different stages of preclinical autoimmunity in a Sjögren's syndrome model among multiple strains of inbred mice.

Sjögren's syndrome is a chronic illness manifested characteristically by immune injury to the salivary and lacrimal glands, resulting in dry mouth/eyes. Anti-Ro [Sjögren's syndrome antigen A (SSA)] and anti-La [Sjögren's syndrome antigen B (SSB)] autoantibodies are found frequently in Sjögren's subjects as well as in individuals who will go on to develop the disease. Immunization of BALB/c mice with Ro60 peptides results in epitope spreading with anti-Ro and anti-La along with lymphocyte infiltration of salivary glands similar to human Sjögren's. In addition, these animals have poor salivary function/low saliva volume. In this study, we examined whether Ro-peptide immunization produces a Sjögren's-like illness in other strains of mice. BALB/c, DBA-2, PL/J, SJL/J and C57BL/6 mice were immunized with Ro60 peptide-274. Sera from these mice were studied by immunoblot and enzyme-linked immunosorbent assay for autoantibodies. Timed salivary flow was determined after pharmacological stimulation, and salivary glands were examined pathologically. We found that SJL/J mice had no immune response to the peptide from Ro60, while C57BL/6 mice produced antibodies that bound the peptide but had no epitope spreading. PL/J mice had epitope spreading to other structures of Ro60 as well as to La, but like C57BL/6 and SJL/J had no salivary gland lymphocytic infiltration and no decrement of salivary function. DBA-2 and BALB/c mice had infiltration but only BALB/c had decreased salivary function. The immunological processes leading to a Sjögren's-like illness after Ro-peptide immunization were interrupted in a stepwise fashion in these differing mice strains. These data suggest that this is a model of preclinical disease with genetic control for epitope spreading, lymphocytic infiltration and glandular dysfunction.

Using a mobile phone-based application as an adjunct to facilitate oral hygiene practices in children with Attention Deficit Hyperactivity Disorder (ADHD).

AIM: To evaluate the efficacy of a mobile phone application to facilitate oral hygiene practices in children with ADHD. METHODS: This was a randomized controlled study that included 54 ADHD children after obtaining informed parental consent. The children were randomly divided into 2 groups; Group 1 (conventional) participants were instructed verbally as well as demonstrated the brushing technique on models. Group 2 (mobile phone application) participants were made to download and use the 'BRUSH DJ' app developed by Ben Underwood. At baseline, the oral hygiene index-simplified (OHI-S) [Greene and Vermillion, 1964] of each child was evaluated clinically and the parents were asked to fill a questionnaire regarding the oral hygiene practices followed by their child every day. At the end of the second, sixth, and twelfth week, the parents were asked to fill the same questionnaire in addition to the evaluation of the OHI-S index. RESULTS: A significant difference was found in the brushing time, brushing frequency, and OHI-S index between group 1 and group 2 at the end of 12 weeks. (unpaired t-test, p<0.05) CONCLUSION: The mobile phone application proved to be an effective tool in captivating the attention of these children and thus improving their oral health.

A morphological study of variations in the branching pattern and termination of the radial artery.

INTRODUCTION: Coronary artery bypass grafting is an established means of treating advanced coronary artery disease. In recent years, there has been an increased interest in the radial artery as an entry route during coronary angiography. Accurate knowledge of the branching pattern of this artery and its relation to surrounding structures is of great importance in the care of surgical patients. METHODS: This study was conducted on 75 formalin-fixed upper limbs in order to note the variations in the branching pattern and termination of the radial artery. RESULTS: The radial artery divided into three branches in 2.7% of cases and into two branches in 52.0% of cases. The radial recurrent artery originated from the brachial artery instead of the radial artery in 12.0% of cases. The radial recurrent artery, palmar carpal artery, first dorsal metacarpal artery and superficial palmar artery were absent in 1.3%, 26.7%, 9.3% and 5.3% of cases, respectively. 6.7% of cases had a high origin of the superficial palmar artery. CONCLUSION: The rich photographic documentation of the variation of branching pattern and termination of radial artery is not only of academic interest but also useful to surgeons and radiologists working in the same area.

Hiponatremia, mielinólisis pontina y rabdomiólisis

Presentamos un caso donde la conexión entre la hiponatremia, la mielinólisis pontina y la rabdomiólisis evidencia la necesidad de que el tratamiento se realice tomando en cuentael carácter agudo o crónico del desequilibrio electrolítico, así como la ponderación adecuada de su expresión clínica. Varón de 41 años que ingresó por vómitos,convulsiones tonicoclónicas generalizadas y rigidez. Al llegar a Urgencias, el paciente estabaestuporoso, con respuestas limitadas alos estímulos dolorosos y una fuerte hipertonía fundamentalmente de la musculatura axial. Ingresó en la Unidad de Cuidados Intensivosy se detectó un desequilibrio electrolíticoimportante, ya que sus cifras de sodio(100 mM/L), potasio (2,5 mM/L) y cloro (65 mM/L) eran inquietantemente bajas, elemento que se asoció al incremento sustancial de losniveles séricos de mioglobina (2.077 ng/L) creatinfosfocinasa (1.401 U/L) y, en menor grado, creatinina (171 mM/L). Una resonancia magnética en corte sagital ponderado en T1 poscontraste y corte axial ponderadoen T2 mostró un área hiperdensa en laprotuberancia dorsomedial, lo que se corresponde con una mielinólisis pontina....

Hemorragia talámica en una paciente con la enfermedad de Moyamoya

La estrechez y oclusión progresiva de la porción distal de las arterias carótida interna, cerebral medial proximal o cerebral anterior, y de sus ramas mayores puede resultar en la hipertrofiade las arterias lenticuloestriadas. Consecuentemente, una fina red de colaterales se forma desde el segmento ocluido en la vecindad del área estenótica. Se describe un caso hemorrágico de moyamoyaque afecta el tálamo. Ésta es una atípicaforma de presentación, puesto que las hemorragias en pacientes no japoneses no exceden del 5 por ciento. Se trata de una mujer pakistaní de 47 años, hipertensa, que presentó, de manera súbita, cefalea, mareos y hemiparesia izquierda, asociados a un nivel deconciencia fluctuante....

Intoxicación por monóxido de carbono, rabdomiólisis, petequias cerebrales y evolución fatal

La intoxicación por monóxido de carbono (CO) es una urgencia médica que, de no tratarse oportunamente, puede dejar considerables secuelas neurológicas o incluso provocar la muerte del paciente. El cuadro clínico desencadenado por la intoxicación por CO depende de la intensidad de la exposición a este gas y varía según el grado de afectación de los distintos órganos y sistemas involucrados. El sistema nervioso, dadas sus características de especial dependencia de una adecuada oxigenación, es extremadamente sensible a la presencia del CO en el organismo, debido a su afinidad por la hemoglobina, unas 200 veces mayor que la del oxígeno; por ello, mínimas cantidades de CO a un nivel constante pueden desencadenar daños considerablesen personas susceptibles. El espectro de síntomas neurológicos es variable y depende de la intensidad de la exposición y de una serie de factores predisponentes que puedeninclinar la balanza según el caso...