Hair loss at injection sites of mesotherapy for alopecia.

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El-Komy, Mohamed; Hassan, Akmal; Tawdy, Amira; Solimon, Mohamed; Hady, Mohamed Abdel

2017-12-01

The side effects of mesotherapy for treatment of various forms of alopecia are often underreported, while scientific data for its efficacy are severely lacking. To demonstrate the late onset side effects of mesotherapy for alopecia. Three patients with androgenetic alopecia showed hair loss after previously uneventful mesotherapy sessions up to 1 year. Clinical, dermoscopic, and histopathological findings suggested an inflammatory scaring process at sites of mesotherapy injections. Mesotherapy for androgenetic alopecia may paradoxically induce hair loss and scarring. Proper regulation and monitoring of the use of mesotherapy products for treating hair loss in women, needs to be addressed. © 2017 Wiley Periodicals, Inc.

Understanding Autoimmunity of Vitiligo and Alopecia Areata

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Rork, Jillian F.; Rashighi, Mehdi; Harris, John E.

2016-01-01

Purpose of review Vitiligo and alopecia areata are common, disfiguring skin diseases. Treatment options are limited and include non-targeted approaches such as corticosteroids, topical calcineurin inhibitors, narrow band UVB phototherapy, and other immune-modifying agents. The purpose of this article is to review shared, novel mechanisms between vitiligo and alopecia areata, as well as discuss how they inform the development of future targeted treatments. Recent findings Vitiligo and alopecia areata are both autoimmune diseases, and striking similarities in pathogenesis have been identified at the level of both the innate and adaptive immune system. Increased reactive oxygen species and high cellular stress level have been suggested as the initiating trigger of the innate immune system in both diseases, and genome-wide association studies have implicated risk alleles that influence both innate and adaptive immunity. Most importantly, mechanistic studies in mouse models of vitiligo and alopecia areata have specifically implicated an IFN-γ-driven immune response, including IFN-γ, IFN-γ-induced chemokines, and cytotoxic CD8+ T cells as the main drivers of disease pathogenesis. These recent discoveries may reveal an effective strategy to develop new treatments, and several proof-of-concept clinical studies support this hypothesis. Summary The identification of IFN-γ-driven immune signaling pathways has enabled discoveries of potential new treatments for vitiligo and alopecia areata, and supports initiation of larger clinical trials. PMID:27191524

Color dilution alopecia in a blue Doberman pinscher crossbreed

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Perego, Roberta; Proverbio, Daniela; Roccabianca, Paola; Spada, Eva

2009-01-01

A 6-year-old male, blue Doberman pinscher crossbreed was presented with coat abnormalities; in particular, flank alopecia and pruritus. Based on medical the history, clinical evidence, and histopathological examination, color dilution alopecia was diagnosed. The dog was with oral melatonin treated for 3 months without success.

Color dilution alopecia in a blue Doberman pinscher crossbreed.

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Perego, Roberta; Proverbio, Daniela; Roccabianca, Paola; Spada, Eva

2009-05-01

A 6-year-old male, blue Doberman pinscher crossbreed was presented with coat abnormalities; in particular, flank alopecia and pruritus. Based on medical the history, clinical evidence, and histopathological examination, color dilution alopecia was diagnosed. The dog was with oral melatonin treated for 3 months without success.

Annotating temporal information in clinical narratives.

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Sun, Weiyi; Rumshisky, Anna; Uzuner, Ozlem

2013-12-01

Temporal information in clinical narratives plays an important role in patients' diagnosis, treatment and prognosis. In order to represent narrative information accurately, medical natural language processing (MLP) systems need to correctly identify and interpret temporal information. To promote research in this area, the Informatics for Integrating Biology and the Bedside (i2b2) project developed a temporally annotated corpus of clinical narratives. This corpus contains 310 de-identified discharge summaries, with annotations of clinical events, temporal expressions and temporal relations. This paper describes the process followed for the development of this corpus and discusses annotation guideline development, annotation methodology, and corpus quality. Copyright © 2013 Elsevier Inc. All rights reserved.

Alopecia secondary to mesotherapy.

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Duque-Estrada, Bruna; Vincenzi, Colombina; Misciali, Cosimo; Tosti, Antonella

2009-10-01

Mesotherapy has recently become an advertised method for the treatment of different types of alopecia despite the lack of any data regarding its efficacy and possible side effects. The substances injected into the scalp include "cocktails" of natural plant extracts, homoeopathic agents, vitamins, vasodilators, and drugs that may stimulate hair growth, such as finasteride and minoxidil. We report two cases of patchy alopecia that developed after mesotherapy for the treatment of androgenetic alopecia. In the first patient, alopecia developed after injections of the heparinoid vasodilator mesoglycan; the 3-month follow-up examination revealed a small residual area of cicatricial alopecia. The second patient developed reversible alopecia after multiple scalp injections of homeopathic agents. These cases underline the possible risks of mesotherapy as a therapeutic technique for hair loss.

Psoriatic Alopecia in a Patient with Systemic Lupus Erythematosus

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Wimolsiri Iamsumang

2017-03-01

Full Text Available Psoriasis is a chronic, recurrent, and relatively common inflammatory dermatologic condition, which demonstrates various clinical manifestations including hair loss. It was once believed that alopecia was not a presentation of scalp psoriasis, but it is now widely accepted that psoriatic alopecia exists. Although the majority of patients get hair regrowth, it can potentially lead to permanent hair loss. Herein, we report a case of 26-year-old female patient with systemic lupus erythematosus who presented with scalp hair loss and nonpruritic scaly plaques on the scalp. Her clinical presentation, dermoscopic, and histopathologic findings were consistent with psoriatic alopecia. Additionally, we also described a novel scalp dermoscopic pattern of “patchy dotted vessels” which we detected in the lesion of scalp psoriasis.

Alopecia neoplastica: An uncommon presentation of metastatic breast carcinoma

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Felipe Ladeira de Oliveira

2016-12-01

Full Text Available Cutaneous metastasis may correspond to the initial clinical presentation of hidden internal malignancies. In patients presenting said neoplasia, clinical manifestations of breast cancer reaches 23.9%. Considering that neoplastic alopecia appears as an unusual pattern of the said metastasis, this report describes a case of such uncommon neoplastic alopecia which presents itself as a cutaneous metastasis of rapid progression in a patient with prior breast cancer history. We present a 47-year-old female patient reporting lesions at the scalp, and who was asymptomatic with a 1-year evolution. The patient reported prior breast cancer history and presence of lung metastasis, and was undergoing chemotherapy at the time of consultation. A dermatological evaluation showed only a nodular lesion with erythematous surface and a diameter measuring about 4 cm, firm in consistency, and immovable. She was routed to the Department of Dermatological Surgery, and the results from histopathology were consistent with a diagnosis of metastatic breast adenocarcinoma. Neoplastic alopecia appears as an unusual form of cutaneous metastasis which is predominantly described in association with breast cancer. The lesion’s clinical features play a crucial role at the differential diagnosis, as the presence of erythema could distinguish neoplastic alopecia from alopecia areata. The existence of cutaneous metastasis leads to unfavorable outcomes. As a conclusion, cutaneous evaluation of patients is essential for treating visceral metastases, since the forms of cutaneous metastasis are diverse and can also affect the scalp.

Topical Melatonin for Treatment of Androgenetic Alopecia

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Fischer, Tobias W; Tr?eb, Ralph M; H?nggi, Gabriella; Innocenti, Marcello; Elsner, Peter

2012-01-01

Background: In the search for alternative agents to oral finasteride and topical minoxidil for the treatment of androgenetic alopecia (AGA), melatonin, a potent antioxidant and growth modulator, was identified as a promising candidate based on in vitro and in vivo studies. Materials and Methods: One pharmacodynamic study on topical application of melatonin and four clinical pre-post studies were performed in patients with androgenetic alopecia or general hair loss and evaluated by standardise...

Androgenetic alopecia: a review.

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Lolli, Francesca; Pallotti, Francesco; Rossi, Alfredo; Fortuna, Maria C; Caro, Gemma; Lenzi, Andrea; Sansone, Andrea; Lombardo, Francesco

2017-07-01

Androgenetic alopecia, commonly known as male pattern baldness, is the most common type of progressive hair loss disorder in men. The aim of this paper is to review recent advances in understanding the pathophysiology and molecular mechanism of androgenetic alopecia. Using the PubMed database, we conducted a systematic review of the literature, selecting studies published from 1916 to 2016. The occurrence and development of androgenetic alopecia depends on the interaction of endocrine factors and genetic predisposition. Androgenetic alopecia is characterized by progressive hair follicular miniaturization, caused by the actions of androgens on the epithelial cells of genetically susceptible hair follicles in androgen-dependent areas. Although the exact pathogenesis of androgenetic alopecia remains to be clarified, research has shown that it is a polygenetic condition. Numerous studies have unequivocally identified two major genetic risk loci for androgenetic alopecia, on the X-chromosome AR⁄EDA2R locus and the chromosome 20p11 locus. Candidate gene and genome-wide association studies have reported that single-nucleotide polymorphisms at different genomic loci are associated with androgenetic alopecia development. A number of genes determine the predisposition for androgenetic alopecia in a polygenic fashion. However, further studies are needed before the specific genetic factors of this polygenic condition can be fully explained.

[Drug treatment of alopecia].

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Wolff, H

2015-10-01

Alopecia is the term used to describe hairless areas of the scalp. They can follow a specific pattern, be diffuse or circumscript. Androgenetic alopecia (AGA) follows a pattern: in men thinning of temples and vertex up to total baldness; in women thinning of the midline or parietal area. Lack of iron or cytostatic drugs cause diffuse alopecia, while in autoimmune diseases such as alopecia areata or lichen planus bizarre shapes of hairless areas are observed. For therapy, the following medications are used: topical minoxidil solution for AGA of men and women; systemic finasteride 1 mg for men with AGA; topical diphencyprone immunotherapy for alopecia areata; systemic antimycotic agents for tinea capitis; antibiotics such as clindamycin and rifampicin for folliculitis decalvans; systemic corticosteroids and isotretinoin for folliculitis et perifolliculitis capitis abscedens et suffodiens; topical corticosteroids for lichen planus and Kossard's frontal fibrosing alopecia.

Clinical utility and validity of minoxidil response testing in androgenetic alopecia.

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Goren, Andy; Shapiro, Jerry; Roberts, Janet; McCoy, John; Desai, Nisha; Zarrab, Zoulikha; Pietrzak, Aldona; Lotti, Torello

2015-01-01

Clinical response to 5% topical minoxidil for the treatment of androgenetic alopecia (AGA) is typically observed after 3-6 months. Approximately 40% of patients will regrow hair. Given the prolonged treatment time required to elicit a response, a diagnostic test for ruling out nonresponders would have significant clinical utility. Two studies have previously reported that sulfotransferase enzyme activity in plucked hair follicles predicts a patient's response to topical minoxidil therapy. The aim of this study was to assess the clinical utility and validity of minoxidil response testing. In this communication, the present authors conducted an analysis of completed and ongoing studies of minoxidil response testing. The analysis confirmed the clinical utility of a sulfotransferase enzyme test in successfully ruling out 95.9% of nonresponders to topical minoxidil for the treatment of AGA. © 2014 Wiley Periodicals, Inc.

Hair transplantation for the the treatment of post-irradiation alopecia

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Kolasinski, J.; Kolenda, M.; Skowronek, J.

2002-01-01

Treatment of head and neck tumours and of leukaemia often necessitates radiotherapy. However; permanent alopecia in the scalp exposed to irradiation is a common problem. One of the effective methods of treatment of post-irradiation alopecia is hair transplantation. Over a period of 18 years 42 patients were treated at the Hair Clinic Poznan for post-irradiation alopecia. Due to the presence of numerous lesions in the donor and recipient scalp areas many modifications were introduced into alopecia correction. The treatment assured good cosmetic effects, free of the risk of complications. Scalps from occipital areas do not go bald when transferred to scalp areas affected by balding. On the contrary - they retain original properties, thus resulting in hair re-growth. Hair follicle transplantation is usually applied for the correction of androgenic alopecia in men and women although it may also be applied in post-trauma and post-irradiation alopecia treatment. Hair regrowth in radiotherapy patients occurs later than in androgenic alopecia patients. This phenomenon is caused by blood supply deficits in the recipient area. Autogenic hair follicle transplantation is a treatment of choice in the correction of post-irradiation alopecia, while the good cosmetic effects considerably improve the patients' quality of life. (author)

Dermoscopic findings in female androgenetic alopecia Achados dermatoscópicos na alopecia androgenética feminina

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Lya Duarte Ramos

2012-10-01

Full Text Available BACKGROUND: Androgenetic alopecia is the most common form of hair loss. It is a clinical entity of relevant interest and presents a significant psychosocial impact as it undermines self-esteem and quality of life in female patients due to the importance of the hair for people's facial balance. OBJECTIVE: The purpose of the present study is to evaluate dermoscopic signs in women clinically diagnosed with androgenetic alopecia. METHOD: Observational study with 34 women between 17 and 68 years old who were diagnosed with androgenetic alopecia. All of them underwent photographic sessions with a 10x magnification dermoscope and a digital camera zoom set to 20x magnification and 40x magnification on the scalp frontal midline. RESULTS: All patients showed miniaturization. A peripilar brown halo was found in 22 patients, honeycomb-like scalp pigmentation was found in 14 and yellow dots in only 1 patient. Recent studies show dermoscopy as the new tool for diagnosis assistance and treatment follow up in scalp disorders. Our study used an ordinary dermoscope and we evaluated several findings reported in the literature with significant clarity and easiness. CONCLUSION: The dermoscope, which is used by dermatologists on a daily basis, is an excellent tool to assist in early diagnosis and assessment of therapeutic response in androgenetic alopecia.FUNDAMENTOS: Alopecia androgenética é forma mais comum de queda de cabelo. Constitui entidade clínica de interesse relevante e acarreta grande impacto psicossocial por comprometer a auto-estima e a qualidade de vida das pacientes. OBJETIVO: Procurar os sinais dermatoscópicos comuns em mulheres com diagnóstico clínico de alopecia androgenética, visando diagnóstico precoce e melhor resposta terapêutica. MÉTODOS: Estudo observacional em 34 mulheres com idades entre 17 e 68 anos, com diagnóstico clínico de alopecia androgenética. Todas pacientes foram avaliadas e submetidas a registros fotográficos com o

The usefulness of dermoscopy in canine pattern alopecia: a descriptive study.

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Zanna, Giordana; Roccabianca, Paola; Zini, Eric; Legnani, Sara; Scarampella, Fabia; Arrighi, Silvana; Tosti, Antonella

2017-02-01

Dermoscopic studies evaluating noninflammatory, nonpruritic progressive alopecia attributable to pattern alopecia are currently unavailable. To evaluate the dermoscopic features observed in healthy skin of short coated dogs and compare these findings with those observed in dogs affected by pattern alopecia diagnosed by clinical and dermatopathological examination. Thirty male and female, healthy, breed matched, young adult, short coated dogs (controls) and 30 male and female, young adult, short coated dogs affected by pattern alopecia. Dermoscopy was performed with a Fotofinder II videodermoscope equipped with software that allowed the measurement of structures visualized in magnified images (20×-40×-70×). Skin biopsy samples were obtained from the thorax and evaluated dermoscopically for dermoscopic-histological correlation in affected dogs. Dermoscopic findings in canine pattern alopecia were hair shaft thinning, circle hairs and follicular keratin plugs; in the affected sun exposed areas there was a honeycomb-like pattern of pigmentation. Arborizing red lines reflecting vascularization were classified as a nonspecific finding because they were also common in healthy dogs. Dermoscopic features correlated with histology for selected hair follicle abnormalities. Although canine pattern alopecia is a visually striking disease, this study supports the value of dermoscopy for clinical examination and also opens promising perspectives for the identification of diagnostic dermoscopic patterns that may be useful for other skin disorders. © 2016 ESVD and ACVD.

EFECTIVITY MINOXIDIL AS A TREATMENT OF ALOPECIA AREATA

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Wayan Evie Frida Yustin

2014-01-01

Full Text Available Alopecia areata is hair loss with patchy formation, the most common cause of alopecia nonscarring. Occurred in 1,7 % of Americans aged 50 years. Canoccurs in both sexes, all races and any age. Genetic and immunological factorsplay an important role as a cause of Alopecia areata. The clinical features alopecia areata are round or oval lesions, total baldness, smoothness on the scalpor other parts of the body that has hair. Minoxidil is one of the effective therapyfor Alopecia areata. Known for more than 30 years of minoxidil to stimulate hairgrowth. Minoxidil works on hair follicles, opening the potassium channels, andhave vascular effects that can increase blood flow to hair. Histological studiesshowed that minoxidil therapy may increase the proportion hair follicles in anagenphase and decrease hair follicles at telogen phase. Minoxidil through sulphatmetabolites can open potassium channels, the opening potassium channels canincrease the hair follicles growth. The study of the effects minoxidil on humanepidermal keratinocytes and hair follicles with different culture conditions andmarkers proliferation, found that minoxidil with micro molar concentration canstimulate proliferation both type of cells and all culture condition, whereasminoxidil with milimolar concentration will inhibit cell growth. In addition,several studies have also reported an association minoxidil to vascular effect andstimulating VEGF can promote the increase hair follicle

Updated meta-analysis of the relation between heart disease and androgenic alopecia or alopecia areata

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Misato Amamoto

2018-01-01

Full Text Available Background The relationship between baldness and heart disease is still controversial. We performed an updated meta-analysis of observational studies to evaluate the relation between heart disease and androgenic alopecia or alopecia areata. Aims To evaluate the relation between heart disease and androgenic alopecia or alopecia areata. Methods Studies were identified by searching Medline and Embase up to October 20, 2017 without language restriction. Metaanalysis was performed by using a random-effects model. Results Nine studies were included in the meta-analysis (eight on androgenic alopecia and one on alopecia areata: 44,806 participants. Compared to men without baldness, men with androgenic alopecia had an increased risk of heart disease (relative risk (RR: 1.32, 95 per cent CI: 1.08 to 1.63, p=0.01, I2 =25 per cent, and younger men (<55 or ≤60 years showed a stronger association (RR: 1.44, 95 per cent CI: 1.11 to 1.86, p=0.01, I2 =0 per cent. The positive relation depended on the severity of baldness and decreased in order of severe vertex (RR: 1.60, 95 per cent CI: 1.19 to 2.16, p=0.002, moderate vertex (RR: 1.41, 95 per cent CI: 1.22 to 1.64, p<0.001, mild vertex (RR: 1.18, 95 per cent CI: 1.05 to 1.33, p=0.007, and frontal baldness (RR: 1.10, 95 per cent CI: 0.92 to 1.32, p=0.28. In contrast, there was no significant relation between alopecia areata and heart disease (RR: 0.91, 95 per cent CI: 0.60 to 1.39, p=0.66. Conclusion Androgenic alopecia is associated with heart disease, but alopecia areata is not.

Occipital alopecia following cardiopulmonary bypass.

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Lwason, N W; Mills, N L; Ochsner, J L

1976-03-01

Postoperative alopecia is a minor complication of surgery but a cosmetic disaster to the patient. Over a 3 year period, 60 cases of occipital alopecia were discovered in patients following open-heart surgery and 5 cases on other surgical services. In contrast to previous reports, 29 patients had alopecia one year later, presumed to be permanent. Extensive operations, with prolonged recovery and elective overnight mechanical ventilation, were common to all. Retrospective analysis and prospective studies clearly demonstrated that localized scalp pressure was the cause of the alopecia and that the duration of pressure determined the extent of the damage. Moving the patient's head at regular intervals during operation and recovery eliminated the alopecia. The type of head rest used did not modify the development of alopecia. Electrical injury and the use of heparin, hypothermia, electrocautery, or hypotension were eliminated as possible causes. Conclusive evidence correlating periperative events with the formation of pressure sores in man has not been previously reported.

Randomized clinical trial comparing 5% and 1% topical minoxidil for the treatment of androgenetic alopecia in Japanese men.

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Tsuboi, Ryoji; Arano, Osamu; Nishikawa, Tooru; Yamada, Hidekazu; Katsuoka, Kensei

2009-08-01

Minoxidil is efficacious in inducing hair growth in patients with androgenetic alopecia by inducing hair follicles to undergo transition from the early to late anagen phase. Although the efficacy of 1% topical minoxidil has been confirmed in Japan, no controlled study of 5% topical minoxidil has been conducted using male Japanese subjects. The objective of this trial was to verify the superiority in clinical efficacy of 5% topical minoxidil to 1% topical minoxidil in a double-blind controlled study with male, Japanese androgenetic alopecia patients as the subjects. The trial included 300 Japanese male patients aged 20 years or older with androgenetic alopecia who were administered either 5% topical minoxidil (n = 150) or 1% topical minoxidil (n = 150) for 24 weeks. The mean change from the baseline in non-vellus hair/cm(2), the primary efficacy variable, was 26.4 (n = 142) in the 5% topical minoxidil group and 21.2 (n = 144) in the 1% topical minoxidil group at 16 weeks, the main time point for the evaluation. The difference between the groups was significant (P = 0.020). The incidence of adverse events was 8.7% (13/150) in the 5% group and 5.3% (8/150) in the 1% group, with no significant difference between the groups (chi(2)-test: P = 0.258). Our findings confirmed the superiority of 5% topical minoxidil to 1% topical minoxidil in treating Japanese men with androgenetic alopecia.

Central centrifugal cicatricial alopecia: challenges and solutions

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Herskovitz I

2016-08-01

Full Text Available Ingrid Herskovitz, Mariya Miteva Department of Dermatology and Cutaneous Surgery, University of Miami L Miller School of Medicine, Miami, FL, USA Abstract: Central centrifugal cicatricial alopecia (CCCA is the most common scarring alopecia among African American women. Data about epidemiology, etiology, genetic inheritance, and management are scarce and come from individual reports or small series. CCCA has been associated with hot combing and traumatic hair styling for years; however, studies fail to confirm it as the sole etiologic factor. It has been shown in a small series that CCCA can be inherited in an autosomal dominant fashion, with a partial penetrance and a strong modifying effect of hairstyling and sex. CCCA presents clinically as a central area of progressive irreversible hair loss that expands to the periphery. A patchy form has also been described. Dermoscopy is helpful to identify the optimal site for the biopsy, which establishes the diagnosis. Well-designed randomized controlled trials are needed to discover the optimal management. At this point, patients are advised to avoid traction and chemical treatments; topical and intralesional steroids, calcineurin inhibitors, and minoxidil can be helpful in halting the progression. Keywords: hair loss, alopecia, dermatoscopy, dermoscopy, trichoscopy, black scalp, African American, scarring alopecia

Higher body mass index is associated with greater severity of alopecia in men with male-pattern androgenetic alopecia in Taiwan: a cross-sectional study.

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Yang, Chao-Chun; Hsieh, Fu-Nien; Lin, Li-Yu; Hsu, Chao-Kai; Sheu, Hamm-Ming; Chen, WenChieh

2014-02-01

Obesity is a risk factor for multiple health problems, but its association with androgenetic alopecia (AGA) remains controversial. We sought to determine the association between body mass index (BMI) and alopecia severity in men with AGA and early-onset AGA. A cross-sectional study was conducted. The medical charts and photographs of men with a clinical diagnosis of AGA were reviewed. In all, 189 men were enrolled with a mean age of 30.8 years. In male-pattern AGA (n = 142), men with severe alopecia (grade V-VII) had higher BMI than those with mild to moderate alopecia (grade I-IV) (25.1 vs 22.8 kg/m(2), P = .01). After multivariate adjustments, the risk for severe alopecia was higher in the overweight or obese (BMI ≥24 kg/m(2)) subjects with male-pattern AGA (odds ratio 3.52, P < .01). In early-onset male-pattern AGA (n = 46), the risk for having severe alopecia was also higher in the overweight or obese subjects (odds ratio 4.97, P = .03). Parameters used to evaluate obesity were limited because of the retrospective nature of the study. Higher BMI was significantly associated with greater severity of hair loss in men with male-pattern AGA, especially in those with early-onset AGA. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Cognitive-behavioural psychotherapy and alopecia areata

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Marta Kuty-Pachecka

2017-06-01

Full Text Available Alopecia areata (also known as spot baldness is a disease with multifactorial aetiology, including genetic, hormonal, autoimmune and  psychological factors as well as nervous system disorders. This disorder belongs to  the group of dermatological conditions modified by psychological factors. Clinical experience indicates that stress and psychological aspects contribute significantly to the onset and/or exacerbation of alopecia areata. Pharmacological treatment of this dermatosis is often ineffective or insufficient. Therefore, a holistic approach to the disease, including both medical and  psychological aspects, is  crucial. It  is  emphasised in  the subject literature that some forms of  psychotherapy and pharmacotherapy used in patients with alopecia areata improve their psychophysical condition, and, consequently, stimulate the regrowth of their hair. Research has shown that cognitive-behavioural therapy complements dermatological treatment of alopecia areata, improving the quality of life of patients. The aim of cognitive and behavioural techniques is, on the one hand, to change the maladaptive negative convictions about oneself, the world, and the disease, and, on the other hand, to acquire the ability to cope with negative emotional states and difficult situations, such as a disease. The aim of the paper is to present the results of a literature review on the efficiency of pharmacotherapy and the role of cognitive-behavioural therapy in alopecia areata.

Alopecia Areata Associated with Localized Vitiligo

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Shankarling D. Kuchabal

2010-03-01

Full Text Available Alopecia areata is a common cause of noncicatricial alopecia that occurs in a patchy, confluent or diffuse pattern. It may occur as a single, self-limiting episode or may recur at varying intervals over many years. The association of alopecia areata with localized vitiligo has not been reported. The association of alopecia areata with localized vitiligo in the same patient is documented here; it is the first of its kind.

Naked Hair Shafts as a Marker of Cicatricial Alopecia.

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Doytcheva, Kristina; Tan, Timothy; Guitart, Joan; Gerami, Pedram; Yazdan, Pedram

2018-07-01

Naked hair shafts (NHS) are free-floating hair shafts devoid of surrounding epithelium, supporting structures, and/or embedded in inflammation that may result from destruction of hair follicles by scarring processes such as inflammation and fibroplasia. Extensive examination of NHS has not been performed in scalp biopsies of alopecia. We retrospectively evaluated 622 scalp biopsies of alopecia [345 cicatricial alopecias (central centrifugal cicatricial alopecia, lichen planopilaris, discoid lupus erythematosus, acne keloidalis nuchae, and folliculitis decalvans] and 277 non-cicatricial alopecias [alopecia areata, androgenic alopecia, telogen effluvium, and psoriatic alopecia)] for the presence of NHS. NHS occurred in 0.72% (2/277) of non-cicatricial alopecias (1/102 of alopecia areata, 1/150 of androgenic alopecia, 0/17 of telogen effluvium, and 0/8 of psoriatic alopecia) and 20% (72/345) of cicatricial alopecias (27/118 of central centrifugal cicatricial alopecia, 29/109 of lichen planopilaris, 2/75 of discoid lupus erythematosus, 11/16 of acne keloidalis nuchae, and 3/27 of folliculitis decalvans). The presence of NHS was significantly increased in cicatricial alopecias in comparison with non-cicatricial alopecias; P value <0.0001. Among the cicatricial alopecias, 26% (92/345) had mild inflammation and/or fibrosis, of which 9% (9/92) had NHS. There were 73% (253/345) that had moderate to severe inflammation and/or fibrosis, of which 24% (63/253) had NHS, indicating that as the severity of inflammation and fibrosis increases, so does the presence of NHS. NHS rarely occurs in non-cicatricial alopecias. This variation may result from destruction of hair follicles by the inflammatory and scarring processes. The presence of NHS may be a useful adjunctive histopathologic feature in the diagnosis of cicatricial alopecia.

Low-level laser therapy for the treatment of androgenic alopecia: a review.

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Darwin, Evan; Heyes, Alexandra; Hirt, Penelope A; Wikramanayake, Tongyu Cao; Jimenez, Joaquin J

2018-02-01

There are many new low-level laser technologies that have been released commercially that claim to support hair regrowth. In this paper, we will examine the clinical trials to determine whether the body of evidence supports the use of low-level laser therapy (LLLT) to treat androgenic alopecia (AGA). A literature search was conducted through Pubmed, Embase, and Clinicaltrials.gov for clinical trials using LLLT to treat AGA. Thirteen clinical trials were assessed. Review articles were not included. Ten of 11 trials demonstrated significant improvement of androgenic alopecia in comparison to baseline or controls when treated with LLLT. In the remaining study, improvement in hair counts and hair diameter was recorded, but did not reach statistical significance. Two trials did not include statistical analysis, but showed marked improvement by hair count or by photographic evidence. Two trials showed efficacy for LLLT in combination with topical minoxidil. One trial showed efficacy when accompanying finasteride treatment. LLLT appears to be a safe, alternative treatment for patients with androgenic alopecia. Clinical trials have indicated efficacy for androgenic alopecia in both men and women. It may be used independently or as an adjuvant of minoxidil or finasteride. More research needs to be undertaken to determine the optimal power and wavelength to use in LLLT as well as LLLT's mechanism of action.

A study of immunoglobulins and complements (C3 &C4 in alopecia areata

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Sharma R

1995-01-01

Full Text Available Estimation of serum Immunoglobulins (IgG, IgM and IgA and complements (C3 and C4 was carried out in 100 cases of alopecia areata as per method described by Mancini (1965.[1] Clinically patients were divided in two groups, alopecia areata circumscribed (group I and severe alopecia areata (group II. Significant decrease in levels of one or more Immunoglobulins were observed in most of the patients. However, Serum complements (C3 and C4 were within range of normal control values

A review on laser and light-based therapies for alopecia areata.

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Mlacker, Stephanie; Aldahan, Adam Souhail; Simmons, Brian James; Shah, Vidhi; McNamara, Colin Andrew; Samarkandy, Sahal; Nouri, Keyvan

2017-04-01

Alopecia areata is a form of non-scarring alopecia that results from a hyperactive immune response of T cells against hair follicles. Many patients with visible hair loss experience psychological and emotional distress, as a result of their cosmetic disfigurement, and frequently seek treatment. However, existing treatment methods, such as corticosteroids, topical irritants, sensitizing agents, immunosuppressants, and psoralen plus ultraviolet light A, may result in various adverse effects and often lack efficacy. Laser and light treatments offer a safe and effective alternative. This review aims to provide clinicians with a comprehensive summary of laser and light-based modalities used for the treatment of alopecia areata. Currently, the excimer laser is the most widely studied device and has shown positive results thus far. However, the development of future randomized controlled clinical trials will help determine the appropriate treatment protocols necessary, in order to achieve superior clinical outcomes.

Androgens and alopecia.

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Kaufman, Keith D

2002-12-30

Androgens have profound effects on scalp and body hair in humans. Scalp hair grows constitutively in the absence of androgens, while body hair growth is dependent on the action of androgens. Androgenetic alopecia, referred to as male pattern hair loss (MPHL) in men and female pattern hair loss (FPHL) in women, is due to the progressive miniaturization of scalp hair. Observations in both eunuchs, who have low levels of testicular androgens, and males with genetic 5alpha-reductase (5alphaR) deficiency, who have low levels of dihydrotestosterone (DHT), implicate DHT as a key androgen in the pathogenesis of MPHL in men. The development of finasteride, a type 2-selective 5alphaR inhibitor, further advanced our understanding of the role of DHT in the pathophysiology of scalp alopecia. Controlled clinical trials with finasteride demonstrated improvements in scalp hair growth in treated men associated with reductions in scalp DHT content, and a trend towards reversal of scalp hair miniaturization was evident by histopathologic evaluation of scalp biopsies. In contrast to its beneficial effects in men, finasteride did not improve hair growth in postmenopausal women with FPHL. Histopathological evaluation of scalp biopsies confirmed that finasteride treatment produced no benefit on scalp hair in these women. These findings suggest that MPHL and FPHL are distinct clinical entities, with disparate pathophysiologies. Studies that elucidate the molecular mechanisms by which androgens regulate hair growth would provide greater understanding of these differences. Copyright 2002 Elsevier Science Ireland Ltd.

CNTRO: A Semantic Web Ontology for Temporal Relation Inferencing in Clinical Narratives.

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Tao, Cui; Wei, Wei-Qi; Solbrig, Harold R; Savova, Guergana; Chute, Christopher G

2010-11-13

Using Semantic-Web specifications to represent temporal information in clinical narratives is an important step for temporal reasoning and answering time-oriented queries. Existing temporal models are either not compatible with the powerful reasoning tools developed for the Semantic Web, or designed only for structured clinical data and therefore are not ready to be applied on natural-language-based clinical narrative reports directly. We have developed a Semantic-Web ontology which is called Clinical Narrative Temporal Relation ontology. Using this ontology, temporal information in clinical narratives can be represented as RDF (Resource Description Framework) triples. More temporal information and relations can then be inferred by Semantic-Web based reasoning tools. Experimental results show that this ontology can represent temporal information in real clinical narratives successfully.

PHARMACOTHERAPY ALOPECIA ANDROGENETIC IN MEN

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Riezky Januar Pramitha

2013-03-01

Full Text Available Androgenetic alopecia is hair thinning due to the stimulation of hair follicles to androgens. Incidence in men is higher than in women, it is because men have a degree higher 5? reductase. This condition can cause both physical and psychological effects to the patient. Physical effects due to baldness cause hair loss as a function of protection against heat, cold and trauma. While psychologically can affect self-esteem and self-perception of the patient. Androgenetic alopecia in men influenced by the androgen dihydrotestosterone and genetic predisposition, although the physiology remains unclear. Modality in the management of androgenetic alopecia in males patients including pharmacotherapy, hair transplants and cosmetic approach. According to the Food and Drug Administration (FDA, there are two main drugs are safe and effective in the long term given to men with androgenetic alopecia are minoxidil and finasteride. Although the mechanism of action and route of administration are different, but both drugs have similar effectiveness in stopping the progression of androgenetic alopecia in men.

Pistas dermatoscópicas para diferenciar a tricotilomania da alopecia areata em placa Dermoscopic clues to distinguish trichotillomania from patchy alopecia areata

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Leonardo Spagnol Abraham

2010-10-01

Full Text Available INTRODUÇÃO: Tricotilomania e alopecia areata em placa possuem características clínicas e dermatoscópicas semelhantes. OBSERVAÇÕES: O exame dermatoscópico da tricotilomania revela densidade capilar diminuída, cabelos fraturados em diferentes tamanhos, enovelados e vellus, tricoptilose, pontos amarelos com ou sem pontos pretos e ausência de cabelos em "ponto de exclamação". CONCLUSÃO: No contexto de alopecia em placa e cabelos fraturados, a ausência de "pontos de exclamação" sugere o diagnóstico de tricotilomania. Por outro lado, o achado de pontos amarelos sem pontos pretos não afasta o mesmo.BACKGROUND: Trichotillomania and patchy alopecia areata have similar clinical and dermoscopic features. OBSERVATIONS: In trichotillomania, dermoscopy shows decreased hair density, short vellus hair, broken hairs with different shaft lengths, coiled hairs, short vellus hair, trichoptilosis, sparse yellow dots, which may or may not contain black dots and no exclamation mark hairs. CONCLUSIONS: In the case of patchy alopecia and broken hairs, the absence of exclamation mark hairs suggests a diagnosis of trichotillomania. On the other hand, the finding of yellow dots without black dots does not exclude it.

Promising therapies for treating and/or preventing androgenic alopecia.

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McElwee, K J; Shapiro, J S

2012-06-01

Androgenetic alopecia (AGA) may affect up to 70% of men and 40% of women at some point in their lifetime. While men typically present with a distinctive alopecia pattern involving hairline recession and vertex balding, women normally exhibit a diffuse hair thinning over the top of their scalps. The treatment standard in dermatology clinics continues to be minoxidil and finasteride with hair transplantation as a surgical option. Here we briefly review current therapeutic options and treatments under active investigation. Dutasteride and ketoconazole are also employed for AGA, while prostaglandin analogues latanoprost and bimatoprost are being investigated for their hair growth promoting potential. Laser treatment products available for home use and from cosmetic clinics are becoming popular. In the future, new cell mediated treatment approaches may be available for AGA. While there are a number of potential treatment options, good clinical trial data proving hair growth efficacy is limited.

Alopecia areata in children : treatment with diphencyprone

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Schuttelaar, M L; Hamstra, J J; Plinck, E P; Peereboom-Wynia, J D; Vuzevski, V D; Mulder, P G; Oranje, A P

1996-01-01

We assessed the efficacy of diphencyprone (DPCP) treatment in a total of 26 children with alopecia areata (AA). Sixteen children had alopecia areata totalis (AAT) and 10 had alopecia areata localis (AAL). DPCP is an absolute contact sensitizer. Twenty-five children could be sensitized with a 2% DPCP

A review of monochromatic light devices for the treatment of alopecia areata.

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Darwin, Evan; Arora, Harleen; Hirt, Penelope A; Wikramanayake, Tongyu Cao; Jimenez, Joaquin J

2018-02-01

There are many laser technologies that are being tested that claim to support hair regrowth for patients with alopecia areata (AA). In this paper, we will determine whether the body of evidence supports the use of devices using monochromatic light sources to treat AA. Articles were gathered from PubMed, Embase, and the Cochrane database using these keywords: lasers, excimer laser, low-level laser therapy (LLLT), low-level light therapy, alopecia, alopecia areata, and hair loss with a category modifier of English. Ten clinical trials and seven case reports/abstracts were assessed. Eight clinical trials and two case reports demonstrated hair regrowth with the 308-nm excimer laser/light in men, women, and children. One case report demonstrated hair regrowth with the ALBA 355® laser. One clinical trial and two case reports demonstrated hair regrowth with LLLT. While two case reports demonstrated hair regrowth with fractional laser therapy, one clinical trial showed no improvement. The 308-nm excimer laser is a safe and effective treatment for men, women, and children with refractory AA of the scalp and beard. Larger, double-blinded clinical trials should be conducted to compare excimer laser therapy to standard treatments. More data is needed to determine the efficacy of LLLT and fractional laser therapy in the treatment of AA.

Diffuse scarring alopecia in a female pattern hair loss distribution.

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Fergie, Bonnie; Khaira, Gurpreet; Howard, Vicki; de Zwaan, Sally

2018-02-01

We describe three cases of hair loss in a female pattern hair loss (FPHL) distribution with histologic features of lichen planopilaris (LPP). All patients had a history of diffuse, gradual hair loss in a Christmas tree pattern that clinically presented as FPHL on gross and dermoscopic examination. Notably, there were no characteristic clinical signs of LPP and no histologic features of FPHL. These cases are most consistent with cicatricial pattern hair loss (CPHL). This relatively new entity is similar to fibrosing alopecia in a pattern distribution (FAPD) in that they are both scarring alopecias confined to a FPHL distribution, but CPHL lacks the clinical signs of perifollicular erythema and perifollicular keratosis seen in FAPD. These three cases may present an early, subtle form of CPHL and will be of interest to clinicians and histopathologists alike. © 2017 The Australasian College of Dermatologists.

Tofacitinib for the treatment of severe alopecia areata and variants: A study of 90 patients.

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Liu, Lucy Y; Craiglow, Brittany G; Dai, Feng; King, Brett A

2017-01-01

Alopecia areata (AA) is a common autoimmune disorder. There are no reliably effective therapies for AA. We sought to evaluate the safety and efficacy of the Janus kinase 1/3 inhibitor, tofacitinib, in a series of patients over an extended period of time. This is a retrospective study of patients age 18 years or older with AA with at least 40% scalp hair loss treated with tofacitinib. The primary end point was the percent change in Severity of Alopecia Tool (SALT) score during treatment. Ninety patients met inclusion criteria. Of 65 potential responders to therapy, defined as those with alopecia totalis or alopecia universalis with duration of current episode of disease of 10 years or less or alopecia areata, 77% achieved a clinical response, with 58% of patients achieving greater than 50% change in SALT score over 4 to 18 months of treatment. Patients with AA experienced a higher percent change in SALT score than did patients with alopecia totalis or alopecia universalis (81.9% vs 59.0%). Tofacitinib was well tolerated, and there were no serious adverse events. The retrospective nature of the data, the relatively small number of patients, and lack of a control group are limitations. Tofacitinib should be considered for the treatment of severe AA, alopecia totalis, and alopecia universalis; tofacitinib dose response will be better defined by randomized controlled trials. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Survivor of that time, that place: clinical uses of violence survivors' narratives.

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Bhuvaneswar, Chaya; Shafer, Audrey

2004-01-01

Narratives by survivors of abuse offer compelling entries into the experiences of abuse and its effects on health. Reading such stories can enlarge the clinician's understanding of the complexities of abuse. Furthermore, attention to narrative can enhance the therapeutic options for abuse victims not only in mental health arenas, but also in other medical contexts. In this article we define the genre of survivor narratives, examine one such narrative in particular (Push by Sapphire, 1996), and explore the clinical implications of narrative in abuse victims' clinical care.

Psychosocial aspects of androgenetic alopecia

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A. van der Donk (Jos)

1992-01-01

textabstractThe main objective of the studies described in this thesis is to study the psychosocial problems of men and women with androgenetic alopecia who applied for treatment. In chapter 2, the psychological characteristics of 59 men with androgenetic alopecia from a sample of the general

Platelets rich plasma versus minoxidil 5% in treatment of alopecia areata: A trichoscopic evaluation.

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El Taieb, Moustafa A; Ibrahim, Hassan; Nada, Essam A; Seif Al-Din, Mai

2017-01-01

Alopecia areata is a common cause of nonscarring alopecia that occurs in a patchy, confluent, or diffuse pattern. Dermoscopy is a noninvasive technique for the clinical diagnosis of many skin diseases. Topical minoxidil solution 5% and platelet rich plasma are important modalities used in treatment of alopecia areata. We aimed to evaluate the efficacy of PRP versus topical minoxidil 5% in the treatment of AA by clinical evaluation and trichoscopic examination. Ninety patients were allocated into three groups; the first was treated with topical minoxidil 5% solution, the second with platelets rich plasma injections, and the third with placebo. Diagnosis and follow up were done by serial digital camera photography of lesions and dermoscopic scan before and every 1 month after treatment for 3 months. Patients treated with minoxidil 5% and platelets rich plasma both have significant hair growth than placebo (p minoxidil and control (p minoxidil 5% as evaluated by clinical and trichoscopic examination. © 2016 Wiley Periodicals, Inc.

The Relationship between Androgenic Alopecia and Prostate Cancer

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Ghasem Rahmatpour Rokni

2016-07-01

Full Text Available Prostate cancer (PC and Androgenic Alopecia (AGA i are both common diseases in elder men. It seems that androgen plays a crucial role in the growth and development of prostate cancer. Therefore, the current study intended to investigate the relationship between androgenic alopecia and prostate cancer. The present study is a case-control study conducted on 75 patients with prostate cancer (case group referring to Imam Khomeini Hospital in Sari, Iran. The case group was compared with the control group (75 healthy individuals. The intended questionnaire of the study included information such as the age, sex, duration of disease, stage of disease, level of PSA, time diagnosis and time of interview for all the participants. The results of interview and clinical examination along with the patient’s information all were filled in the questionnaire and were statistically analyzed by SPSS after data collection. The mean age of PC group and healthy group was respectively 69.08 ± 8.97 and 68 .45 ± 10.16 years. The average level of PSA was 10.86 ± 11.7 and 2.66 ± 2.7 ng/ml in PC and healthy group in turn. The average duration of cancer was 12.63 ± 9.19 months in PC group. Furthermore, about 6.7% of cancer patients were in stage I, 48% were stage II, 29.3% were in stage III and 16% were in stage IV of prostate cancer. Besides, the number of cancer patients who had both frontal and vertex alopecia (baldness altogether exceeded healthy individuals (P=0.002. According to the results of the present study, there was a significant relationship between prostate cancer and androgenic alopecia which might have been caused by the effect of androgens on both diseases. Consequently, androgenic alopecia can be considered as one of the risk factors associated with prostate cancer.

Topical Minoxidil For the Treatment of Alopecia Areata

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Vinod K Sharma

1986-01-01

Full Text Available One percent minoxidil solution was used topically for the treatment of 10 patients having alopecia areata (4 each having alopecia universalis and totalis and 2 patients with extensive alopecia areata . Significant hair growth did not occur even′ after 3 months of therapy.

Relapsing Polychondritis Following Alopecia Areata

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John C. Starr

2010-01-01

Full Text Available A case of alopecia areata followed by relapsing polychondritis is presented. Similar cases from the literature are reviewed and speculation about the relationship of these diseases is offered. Although the occurrence of these diseases together could be coincidental, an association seems immunologically plausible. Thus, relapsing polychondritis might be an unusual systemic manifestation of alopecia areata.

Platelet-rich plasma in androgenic alopecia: Myth or an effective tool

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Swapna S Khatu

2014-01-01

Full Text Available Platelet-rich plasma (PRP has become a newer method for the treatment of various types of alopecia. In this prospective study, safety, efficacy and feasibility of PRP injections in treating androgenic alopecia were assessed. Eleven patients suffering from hair loss due to androgenic alopecia and not responding to 6 months treatment with minoxidil and finasteride were included in this study. The hair pull test was performed before every treatment session. A total volume of 2-3 cc PRP was injected in the scalp by using an insulin syringe. The treatment was repeated every two weeks, for a total of four times. The outcome was assessed after 3 months by clinical examination, macroscopic photos, hair pull test and patient′s overall satisfaction. Results: A significant reduction in hair loss was observed between first and fourth injection. Hair count increased from average number of 71 hair follicular units to 93 hair follicular units. Therefore, average mean gain is 22.09 follicular units per cm 2. After the fourth session, the pull test was negative in 9 patients. Conclusion: PRP injection is a simple, cost effective and feasible treatment option for androgenic alopecia, with high overall patient satisfaction.

Molecular signatures define alopecia areata subtypes and transcriptional biomarkers

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Ali Jabbari

2016-05-01

Full Text Available Alopecia areata (AA is an autoimmune disease typified by nonscarring hair loss with a variable clinical course. In this study, we conducted whole genome gene expression analysis of 96 human scalp skin biopsy specimens from AA or normal control subjects. Based on gene expression profiling, samples formed distinct clusters based on the presence or absence of disease as well as disease phenotype (patchy disease compared with alopecia totalis or universalis. Differential gene expression analysis allowed us to robustly demonstrate graded immune activity in samples of increasing phenotypic severity and generate a quantitative gene expression scoring system that classified samples based on interferon and cytotoxic T lymphocyte immune signatures critical for disease pathogenesis.

Nail Involvement in Alopecia Areata: A Questionnaire-based Survey on Clinical Signs, Impact on Quality of Life and Review of the Literature

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Roest, Y.B.M.; Middendorp, H.T. van; Evers, A.W.M.; Kerkhof, P.C.M. van de; Pasch, M.C.

2018-01-01

Alopecia areata (AA) is an immune-mediated disease causing temporary or permanent hair loss. Up to 46% of patients with AA also have nail involvement. The aim of this study was to determine the presence, types, and clinical implications of nail changes in patients with AA. This questionnaire-based

Traction alopecia: A neglected entity in 2017

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Christiana Oyinlola Akingbola

2017-01-01

Full Text Available Traction alopecia was first described in 1904 but is still a cause of scarring hair loss in young women worldwide. It is unique in being initially a reversible then an irreversible (scarring form of alopecia. Linked to tightly-pulled hairstyles, it is seen across all races. The pattern of hair loss depends on the style creating it but most commonly affects the frontotemporal hairline. There are some new examination findings associated with traction alopecia, which are traction folliculitis, the fringe sign and hair casts (pseudonits on dermatoscopy. These may prove key in prompting early specialist referral. The mainstay of current treatment is cessation of the contributing hairstyles. Camouflage, anti-inflammatory or growth-stimulating topical preparations are second line treatments. In later stages of severe traction alopecia hair transplantation may be the only effective treatment. The evidence basis for medical intervention with topical agents is anecdotal at best. Furthermore, additional research is required to clarify the pathogenesis of this biphasic alopecia. Until then, prompt diagnosis and identification of causative hairstyles are focus of current dermatological practice.

Plica neuropathica causing traction alopecia

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K Pavithran

1990-01-01

Full Text Available A middle aged woman developed matting of the hairs of the scalp following use of a home made shampoo that contained leaves of Hibiscus rosasiensis. The entangled and matted hair mass in the occipital region pulled hairs of the vertex region of the scalp, resulting in a patch of traction alopecia. Release of tension on the hairs by cutting them with scissors prevented further extension of alopecia.

Radiation-Induced Alopecia after Endovascular Embolization under Fluoroscopy

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Vipawee Ounsakul

2016-01-01

Full Text Available Radiation-induced alopecia after fluoroscopically guided procedures is becoming more common due to an increasing use of endovascular procedures. It is characterized by geometric shapes of nonscarring alopecia related to the area of radiation. We report a case of a 46-year-old man presenting with asymptomatic, sharply demarcated rectangular, nonscarring alopecic patch on the occipital scalp following cerebral angiography with fistula embolization under fluoroscopy. His presentations were compatible with radiation-induced alopecia. Herein, we also report a novel scalp dermoscopic finding of blue-grey dots in a target pattern around yellow dots and follicles, which we detected in the lesion of radiation-induced alopecia.

PUVA treatment of alopecia areata partialis, totalis and universalis: audit of 10 years' experience at St John's Institute of Dermatology

International Nuclear Information System (INIS)

Taylor, C.R.; Hawk, J.L.M.

1995-01-01

Our 10-year experience with PUVA treatment for alopecia areata, partialis, totalis and universalis was retrospectively reviewed using charts and follow-up questionnaires for 70 patients at St John's Institute of Dermatology. In all cases, several previous therapies were judged to be unsatisfactory prior to starting PUVA, and many cases were already deemed clinically refractory prior to referral for PUVA. If cases of vellus hair growth are excluded, and those who lost their PUVA-induced regrowth rapidly on follow-up, the effective success rate was at best 6.3% for alopecia areata partialis, 12.5% for alopecia areata totalis and 13.3% for alopecia areata universalis. We affirm that PUVA is generally not an effective treatment for alopecia areata. (Author)

Managing Chemotherapy Side Effects: Hair Loss (Alopecia)

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... C ancer I nstitute Managing Chemotherapy Side Effects Hair Loss (Alopecia) “Losing my hair was hard at first. ... and anywhere on your body may fall out. Hair loss is called alopecia. When will my hair start ...

Early-onset alopecia and amyotrophic lateral sclerosis: a cohort study.

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Fondell, Elinor; Fitzgerald, Kathryn C; Falcone, Guido J; O'Reilly, Eilis J; Ascherio, Alberto

2013-10-01

A recent meta-analysis of 7 genome-wide association studies on early balding (alopecia) revealed single nucleotide polymorphism variants in the region of the amyotrophic lateral sclerosis (ALS) gene TAR DNA-binding protein 43 (TARDBP/TDP-43). We therefore explored the association of early-onset alopecia and ALS in the Health Professionals Follow-up Study, a large cohort of 51,529 US men. In 1992, the participants (then aged 46-81 years) were asked to report their hair line pattern at age 45 years. During the follow-up period (1992-2008), 42 men were diagnosed with ALS. Of those, 13 had reported no alopecia, 18 had reported moderate alopecia, and 11 had reported extensive alopecia at age 45 years. Those who reported extensive alopecia had an almost 3-fold increased risk of ALS compared with those who reported no alopecia (relative risk = 2.74, 95% confidence interval: 1.23, 6.13). Furthermore, we observed a linear trend of increased risk of ALS with increasing level of balding at age 45 years (Ptrend = 0.02). In conclusion, men with early-onset alopecia seem to have a higher risk of ALS. The mechanisms underlying this association deserve further investigation.

[What is the value of low-energie lasers in the treatment of androgenetic alopecia ?

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Paquet, Ph; Orduz, M; Franchimont, C; Nikkels, A F

2017-12-01

Male and female androgenetic alopecia is a common, chronic, psychologically stressful disorder affecting more than 50 % of the individuals by 50 years of age. Despite the current topical (minoxidil) or oral (the inhibitors of 5-? reductase finasteride or dutasteride) treatments, there is a need for more effective management options. The current clinical evidence, the possible mechanisms of action and the rare adverse events of the low level laser therapy in the treatment of androgenetic alopecia are presented.

Transepidermal drug delivery: a new treatment option for areata alopecia?

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Issa, Maria Claudia Almeida; Pires, Marianna; Silveira, Priscilla; Xavier de Brito, Esther; Sasajima, Cristiane

2015-02-01

Transepidermal drug delivery (TED) is a new potential method in dermatology. Permeability alterations induced by ablative fractional resurfacing have been described with the aim to increasing the delivery of different substances into the skin. To evaluate clinical response and side effects of TED in areata alopecia (AA) treatment using ablative fractional methods associated with acoustic pressure ultrasound (US) to deliver triamcinolone solution into the skin. Five cases of AA underwent treatment which comprised of 3 steps: 1) Ablative fractioned RF or CO2 laser 2) topical application of triamcinolone 3) acoustic pressure wave US. The number of sessions varied according to the clinical response, ranging from one to six sessions. All patients had complete recovery of the area treated. Two of them treated with ablative fractional RF + triamcinolone + US had complete response after three and six sessions. The other two treated with ablative fractional CO2 + triamcinolone + US had complete response after one session. Fractioned ablative resurfacing associated with acoustic pressure wave US is a new option to areata alopecia treatment with good clinical result and low incidence of side effects.

Comparing the demographic factors of patient with limited and diffuse type of alopecia areata

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Mina Daliri

2010-09-01

Full Text Available Background: Alopecia areata is a chronic inflammatory disease that involves the hair follicle. Clinically, patients with alopecia areata may have patchy or confluent hair loss on the scalp or body so we conduct a study to compare the demographic aspects of patient with limited and diffuse type of alopecia areata.Materials and Method: We conducted a descriptive-analyzing study in which 306 patient were chosen. The patients were divided into two groups of diffuse and limited Alopecia. Demographic factors including age, gender, disease onset were compared in two groups. Results: Out of 306 patients, 58.8 % were male and 41.2 % were female. 247 patients (80.7% suffered from limited type and 59 patients (19.2% suffered from diffuse type. The mean age of the onset of involvement in limited group was 21.9±12 yr and 15.8±12 yr in diffuse group. The mean duration of involvement in limited group was 18.7 months and 71 months in diffuse group. Conclusion: Diffuse type alopecia areata starts at lower age and has longer duration. Our study results were similar to the others. Like other studies, thyroid disorders and atopic dermatitis are positively correlative to the severity of disease

Hair breakage as a presenting sign of early or occult central centrifugal cicatricial alopecia: clinicopathologic findings in 9 patients.

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Callender, Valerie D; Wright, Dakara Rucker; Davis, Erica C; Sperling, Leonard C

2012-09-01

Central centrifugal cicatricial alopecia is the most common form of cicatricial alopecia in African American women. Treatment options are limited and mostly aimed at halting further hair loss but rarely result in hair regrowth. Therefore, it is important to recognize early clinical signs, perform a confirmatory biopsy, and begin treatment promptly. We have observed that hair breakage may be a key sign of early central centrifugal cicatricial alopecia, and this association is not clearly described in the literature. Nine patients with hair breakage on the vertex with or without scalp symptoms underwent scalp biopsies as part of their evaluation. Of these, 8 had histologic samples adequate for complete interpretation: 5 specimens (63%) showed histologic changes typical of central centrifugal cicatricial alopecia, with 1 of these showing advanced end-stage changes of cicatricial alopecia. Two (25%) revealed premature desquamation of the inner root sheath as the sole finding suggestive of early central centrifugal cicatricial alopecia and 1 (13%) was normal. Although hair breakage can have multiple causes, early central centrifugal cicatricial alopecia must be considered in the differential diagnosis, particularly in women of African ancestry. Histologic evaluation may reveal early or late findings that can help establish the diagnosis.

Main strategies of specialists’ team work on psychosocial support for women with alopecia

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V. V. Zhyvylko

2017-06-01

Full Text Available In compliance with the principles of bioethics and deontology, during  2013-2017, acomprehensive examination of women with a diagnosis of «total alopecia» was conducted on the basis of the Center for Reconstructive and Restorative Medicine of the Clinic of theOdessaNationalMedicalUniversity. 233 women aged 22 - 45 years old were examined. 76 persons had passed outpatient comprehensive course of author therapy, and 62 persons received treatment in accordance with the «Clinical protocol» but did not receive comprehensive psychosocial assistance. The patients under examination had violations in  psycho-emotional, personal level, level of social functioning. A range of measures of psychosocial support, aimed at providing qualified transdisciplinary help to the patients and their families have been worked out. Their effectiveness is proved on the basis of evidence-based medicine. Within the framework of the research the peculiarities of the psychoemotional sphere of women with total alopecia are determined. Scientifically substantiated, developed and implemented in practice psychosocial support of women with total alopecia, which consisted of psycho-corrective measures using modern mobile e-health technologies. Approbation of measures of psychosocial support showed their effectiveness in 70,89% of cases (р≤0,05. Due to the allocation and systematization of predictors, provocative and supporting factors of diseases, the system of modular medical and social prevention of total alopecia in women was developed, which includes three modules: universal, indicative and selective prevention.

Effect of Cuscuta reflexa Roxb on androgen-induced alopecia.

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Pandit, Shweta; Chauhan, Nagendra Singh; Dixit, V K

2008-09-01

Alopecia is a psychologically distressing condition. Androgenetic alopecia, which affects millions of men and women, is an androgen-driven disorder. Here, Cuscuta reflexa Roxb is evaluated for hair growth activity in androgen-induced alopecia. Petroleum ether extract of C. reflexa was studied for its hair growth-promoting activity. Alopecia was induced in albino mice by testosterone administration for 20 days. Its inhibition by simultaneous administration of extract was evaluated using follicular density, anagen/telogen ratio, and microscopic observation of skin sections. To investigate the mechanism of observed activity, in vitro experiments were performed to study the effect of extract and its major component on activity of 5alpha-reductase enzyme. Petroleum ether extract of C. reflexa exhibited promising hair growth-promoting activity as reflected from follicular density, anagen/telogen ratio, and skin sections. Inhibition of 5alpha-reductase activity by extract and isolate suggest that the extract reversed androgen-induced alopecia by inhibiting conversion of testosterone to dihydrotestosterone. The petroleum ether extract of C. reflexa and its isolate is useful in treatment of androgen-induced alopecia by inhibiting the enzyme 5alpha-reductase.

PUVA treatment of alopecia areata partialis, totalis and universalis: audit of 10 years` experience at St John`s Institute of Dermatology

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Taylor, C.R.; Hawk, J.L.M. [St Thomas` Hospital, London (United Kingdom). St John`s Institute of Dermatology

1995-12-01

Our 10-year experience with PUVA treatment for alopecia areata, partialis, totalis and universalis was retrospectively reviewed using charts and follow-up questionnaires for 70 patients at St John`s Institute of Dermatology. In all cases, several previous therapies were judged to be unsatisfactory prior to starting PUVA, and many cases were already deemed clinically refractory prior to referral for PUVA. If cases of vellus hair growth are excluded, and those who lost their PUVA-induced regrowth rapidly on follow-up, the effective success rate was at best 6.3% for alopecia areata partialis, 12.5% for alopecia areata totalis and 13.3% for alopecia areata universalis. We affirm that PUVA is generally not an effective treatment for alopecia areata. (Author).

Topical minoxidil in the treatment of alopecia areata.

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Fenton, D A; Wilkinson, J D

1983-01-01

A modified double blind crossover study was performed to assess the effect of 1% topical minoxidil as compared with placebo in 30 patients with alopecia areata and alopecia totalis. The active preparation produced a highly significant incidence of hair regrowth. A cosmetically acceptable response was noted in 16 patients. No side effects were seen. The study confirmed that topical minoxidil will induce new hair growth in alopecia areata but that it is less likely to do so in more severe and extensive disease. Furthermore, patients with alopecia universalis and totalis may not respond at all. Nevertheless, as compared with other drugs minoxidil applied topically is relatively non-toxic, is easy to use, and has no systemic or local side effects. Images p1016-a PMID:6412929

Dermatoglyphics in Ichthyosis and Alopecia Areata

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K C Verma

1981-01-01

Full Text Available A total of 80 cases comprising of 40 controls and twenty each of ichthyosis and alopecia areata were studied for dermatoglyphic patterns and ridge count. Statistically significant increased incidence of whorl pattern was observed in female cases of autosomal dominant and sex linked ichthyosis. Significant change in the distribution of patterns was found in female cases of alopecia areata. -

Alopecia: a review of laser and light therapies.

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Rangwala, Sophia; Rashid, Rashid M

2012-02-15

Since the 1980s, laser technology has become increasingly popular to treat a variety of cutaneous conditions. Its successful use as an epilator comes with the rare but interesting side effect of paradoxical hypertrichosis. In this review, we summarize cases describing hair growth after photoepilation, as well as studies testing laser and light sources as treatment for alopecia, particularly androgenetic alopecia and alopecia areata. We also discuss the possible biologic mechanisms by which phototherapy induces hair regeneration.

EFECTIVITY MINOXIDIL AS A TREATMENT OF ALOPECIA AREATA

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Wayan Evie Frida Yustin

2013-07-01

Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Alopecia areata is hair loss with patchy formation, the most common cause of alopecia nonscarring. Occurred in 1,7 % of Americans aged 50 years. Can occurs in both sexes, all races and any age. Genetic and immunological factors play an important role as a cause of Alopecia areata. The clinical features alopecia areata are round or oval lesions, total baldness, smoothness on the scalp or other parts of the body that has hair. Minoxidil is one of the effective therapy for Alopecia areata. Known for more than 30 years of minoxidil to stimulate hair growth. Minoxidil works on hair follicles, opening the potassium channels, and have vascular effects that can increase blood flow to hair. Histological studies showed that minoxidil therapy may increase the proportion hair follicles in anagen phase and decrease hair follicles at telogen phase. Minoxidil through sulphat metabolites can open potassium channels, the opening potassium channels can increase the hair follicles growth. The study of the effects minoxidil on human epidermal keratinocytes and hair follicles with different culture conditions and markers proliferation, found that minoxidil with micro molar concentration can stimulate proliferation both type of cells and all culture condition, whereas minoxidil with milimolar concentration will inhibit cell growth. In addition, several studies have also reported an association minoxidil to vascular effect and stimulating VEGF can promote the increase hair follicle /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso

The case of ichthyosis follicularis, alopecia and photophobia syndrome with retinal detachment

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Bengü Nisa Akay

2014-06-01

Full Text Available Ichtiyosis follicularis, alopecia and photophobia (IFAP syndrome is a rare congenital ectodermal syndrome with X-linked inheritance. It occurs as a result of missense mutation in chromosome Xp22.11-Xp22.13 locus of MBTPS2 gene. It usually affects men and family history is always negative. Ichtiyosis follicularis and alopecia starts with birth. Photophobia and eye symptoms begin in early infancy or childhood. Other manifestations of the syndrome include short stature, mental retardation and seizures. There are no spesific histopathological findings specific for ichtyosis follicularis. A 29 years old male patient was admitted to outpatient clinic. Dermatological examination revealed keratosis pilaris localized to scalp, extremities and anterolateral of the body. Patient had xerosis, diffuse alopecia and prominent folicular appereance. Eye examination revealed cataracts and vision loss. These findings led us to IFAP syndrome diagnosis. The patient is presented for the rarity of the syndrome in the literature.

Hair Loss (Alopecia)

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... care Kids’ zone Video library Find a dermatologist Hair loss Overview Hereditary hair loss: Millions of men ... of hair loss can often be successfully treated. Hair loss: Overview Also called alopecia (al-o-PEE- ...

MedTime: a temporal information extraction system for clinical narratives.

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Lin, Yu-Kai; Chen, Hsinchun; Brown, Randall A

2013-12-01

Temporal information extraction from clinical narratives is of critical importance to many clinical applications. We participated in the EVENT/TIMEX3 track of the 2012 i2b2 clinical temporal relations challenge, and presented our temporal information extraction system, MedTime. MedTime comprises a cascade of rule-based and machine-learning pattern recognition procedures. It achieved a micro-averaged f-measure of 0.88 in both the recognitions of clinical events and temporal expressions. We proposed and evaluated three time normalization strategies to normalize relative time expressions in clinical texts. The accuracy was 0.68 in normalizing temporal expressions of dates, times, durations, and frequencies. This study demonstrates and evaluates the integration of rule-based and machine-learning-based approaches for high performance temporal information extraction from clinical narratives. Copyright © 2013 Elsevier Inc. All rights reserved.

Incidental Syringomas of the Scalp in a Patient with Scarring Alopecia

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Kristyn Deen

2015-07-01

Full Text Available Syringomas are benign adnexal neoplasms of eccrine lineage, which occur most commonly in the periorbital region in middle-aged females. These cutaneous lesions rarely occur on the scalp, are typically asymptomatic and are predominantly of cosmetic significance. Involvement of the scalp may be indistinguishable from that of scarring alopecia. We present an unusual case of clinically inapparent syringomas occurring on the scalp of a 56-year-old female with alopecia who was subsequently diagnosed with lichen planopilaris after repeated scalp biopsy. In patients with unexplained hair loss, or in cases that are refractive to treatment, clinicians should perform scalp biopsy to exclude the diagnosis of rare neoplastic lesions like syringomas and to diagnose associated conditions.

Frontal fibrosing alopecia and lichen planus pigmentosus: diagnosis and therapeutic challenge.

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Mulinari-Brenner, Fabiane Andrade; Guilherme, Marina Riedi; Peretti, Murilo Calvo; Werner, Betina

2017-01-01

Frontal fibrosing alopecia is a variant of lichen planopilaris with marginal progressive hair loss on the scalp, eyebrows and axillae. We report a case of frontal fibrosing alopecia and lichen planus pigmentosus in a postmenopausal woman, that started with alopecia on the eyebrows and then on the frontoparietal region, with periocular and cervical hyperpigmentation of difficult management. The condition was controlled with systemic corticosteroid therapy and finasteride. Lichen planus pigmentosus is an uncommon variant of lichen planus frequently associated with frontal fibrosing alopecia in darker phototipes. It should be considered in patients affected by scarring alopecia with a pattern of lichen planopilaris and areas of skin hyperpigmentation revealing perifollicular hyperpigmentation refractory to multiple treatments. This case illustrates diagnostic and therapeutic challenge in face of scarring alopecia and perifollicular hyperpigmentation.

FAMILIAL ALOPECIA ARETA, ATOPY AND THYROIDITIS HASHIMOTO

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Ani Tsvetanova

2004-10-01

Full Text Available We present a case of morbid association of two organ-specific autoimmune diseases (Alopecia areata-AA and Thyreoiditis Hashimoto-TH in two white sisters - 23 and 26 years old. There is no family history of AA or any autoimmune disorders. The onset of AA, in the both sisters was in early childhood (3 and 7 years of age. The clinical and laboratory examinations showed engagement of the scalp with round or oval large patches of alopecia, without involvement of the body hairs and nails. There were also alterations of thyroid gland function, positive TMA (Thyroid Microsomal Antibodies and Rö-data of Pituitary adenoma as well as episodes of allergic rhinitis (in one of the sisters, and bronchial asthma (in the other. According to Ikeda’s classification, they have an "Atopic type" AA. We suppose that the observed case is not an occasional coincidence of AA and TH. HLA Aw32B18 determination could be support our suggesting about the familial pattern of these autoimmune diseases.

Childhood alopecia areata: A study of 89 patients

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Sibel Doğan

2014-09-01

Full Text Available Background and Design: Alopecia areata (AA is a frequent type of acquired hair loss with a sudden onset. The aim of this study was to investigate the epidemiological and clinical features of AA and diseases associated with AA in the Turkish pediatric population. Materials and Methods: We retrospectively evaluated the medical data of patients under 16 years of age who were admitted to the pediatric dermatology outpatient clinic at Hacettepe University Hospital between 2006 and 2011 with a diagnosis of AA, alopecia totalis (AT and alopecia universalis (AU. Results: A total of 89 patients (34 females and 55 males, were included in this study. The mean age of the subjects was 9.8±3.4 years (range: 18 months-16 years. 9% (n=8 patients had other autoimmune diseases: Hashimoto's thyroiditis in 5, vitiligo in 1, juvenile rheumatoid arthiritis (JRA in 1 and morphea in 1 patient. AA was located on the scalp in 86.5% (n=77 of the patients, 7.9% (n=7 of the patients had AA on the scalp together with eyelashes, eyebrows and the body. AT was noted in 1, AU was noted in 4 patients. Severity of hair loss was <25% in 94.3% (n=84 of the patients according to the involved area. Hashimoto's thyroiditis was diagnosed in 5 patients; these patients had normal thyroid function tests (TFT. TFT abnormalities were detected in 27% (n=24 of the patients. 24.7% (n=22 of these patients were diagnosed with clinically insignificant thyroid disorder, 2 patients had compansated hypothyroidism (n=2. Eight patients (9% patients were found to be positive for anti-thyroid peroxidase antibody (Anti-TPO ab. Antithyroglobulin antibody (Anti-TG Ab elevation was noted in 3.3% (n=3 and antinuclear antibody (ANA positivity was noted in 9% (n=8. Nail changes were detected in 12.3% (n=11 of the patients as leukonychia (n=2, longitudinal striation (n=2, trachyonychia (n=1, onychoschizia (n=1 and pitting (n=1. Conclusion: Childhood AA usually causes limited hair loss. TFT anomalies can

Androgenic alopecia; the risk–benefit ratio of Finasteride

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David L. Rowland

2018-04-01

Full Text Available Finasteride is currently approved and largely used as a therapeutic option for androgenetic alopecia. Apparently a safe drug and effective at the onset, several concerns appeared over time regarding the frequency and magnitude of finasteride adverse effects, which in some cases seem to be even irreversible. This paper presents administration of finasteride in androgenic alopecia from two distinct perspectives. On one hand, androgenic alopecia is a condition that affects especially the self-image and esteem, aspects that are subjective, namely changeable and thus relative. On the other hand, this condition presents a multifactorial etiology, androgens being only in part involved. In addition, androgens have their own physiological roles within the body, so that any androgenic suppression should be carefully advised. Yet, adverse effects induced by Finasteride are only in part documented and treatable. Finally, alternative therapeutic approaches (like topical finasteride become available, so that the oral administration of Finasteride for androgenic alopecia should be in our opinion reevaluated. As a conclusion, a very detailed and informed discussion should take place with such patients accepting to start a therapy with finasteride for androgenic alopecia.

Exacerbation of alopecia areata: A possible complication of sodium tetradecyl sulphate foam sclerotherapy treatment for varicose veins.

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Whiteley, Mark S; Smith, Victoria C

2017-01-01

A 40-year-old woman with a history of alopecia areata related to stress or hormonal changes was treated for bilateral primary symptomatic varicose veins (CEAP clinical score C2S) of pelvic origin, using a staged procedure. Her first procedure entailed pelvic vein embolisation of three pelvic veins using 14 coils and including foam sclerotherapy of the tributaries, using 3% sodium tetradecyl sulphate. Following this procedure, she had an exacerbation of alopecia areata with some moderate shedding of hair. Subsequently, she underwent endovenous laser ablation under local anaesthetic without incident. Seven months after the pelvic vein embolisation, she underwent foam sclerotherapy of leg and labial varicose veins using sodium tetradecyl sulphate. Two days following this procedure, she had a severe exacerbation of alopecia areata with gross shedding of hair. These two episodes of exacerbation of alopecia areata appear to be associated with sodium tetradecyl sulphate foam sclerotherapy of veins.

Female pattern alopecia: current perspectives

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Levy LL

2013-08-01

Full Text Available Lauren L Levy, Jason J Emer Department of Dermatology, Mount Sinai School of Medicine, New York, NY, USA Abstract: Hair loss is a commonly encountered problem in clinical practice, with men presenting with a distinctive pattern involving hairline recession and vertex balding (Norwood-Hamilton classification and women exhibiting diffuse hair thinning over the crown (increased part width and sparing of the frontal hairline (Ludwig classification. Female pattern hair loss has a strikingly overwhelming psychological effect; thus, successful treatments are necessary. Difficulty lies in successful treatment interventions, as only two medications – minoxidil and finasteride – are approved for the treatment of androgenetic alopecia, and these medications offer mediocre results, lack of a permanent cure, and potential complications. Hair transplantation is the only current successful permanent option, and it requires surgical procedures. Several other medical options, such as antiandrogens (eg, spironolactone, oral contraceptives, cyproterone, flutamide, dutasteride, prostaglandin analogs (eg, bimatoprost, latanoprost, and ketoconazole are reported to be beneficial. Laser and light therapies have also become popular despite the lack of a profound benefit. Management of expectations is crucial, and the aim of therapy, given the current therapeutic options, is to slow or stop disease progression with contentment despite patient expectations of permanent hair regrowth. This article reviews current perspectives on therapeutic options for female pattern hair loss. Keywords: androgenetic alopecia, female pattern hair loss, minoxidil, finasteride, antiandrogens, spironolactone

Exacerbation of alopecia areata: A possible complication of sodium tetradecyl sulphate foam sclerotherapy treatment for varicose veins

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Mark S Whiteley

2017-05-01

Full Text Available A 40-year-old woman with a history of alopecia areata related to stress or hormonal changes was treated for bilateral primary symptomatic varicose veins (CEAP clinical score C2S of pelvic origin, using a staged procedure. Her first procedure entailed pelvic vein embolisation of three pelvic veins using 14 coils and including foam sclerotherapy of the tributaries, using 3% sodium tetradecyl sulphate. Following this procedure, she had an exacerbation of alopecia areata with some moderate shedding of hair. Subsequently, she underwent endovenous laser ablation under local anaesthetic without incident. Seven months after the pelvic vein embolisation, she underwent foam sclerotherapy of leg and labial varicose veins using sodium tetradecyl sulphate. Two days following this procedure, she had a severe exacerbation of alopecia areata with gross shedding of hair. These two episodes of exacerbation of alopecia areata appear to be associated with sodium tetradecyl sulphate foam sclerotherapy of veins.

308-nm excimer laser for the treatment of alopecia areata in children.

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Al-Mutairi, Nawaf

2009-01-01

Alopecia areata (AA) is a common skin disease which is characterized by nonscarring localized or diffused hair loss. In this study we assessed the efficacy of 308-nm Excimer laser in the treatment of alopecia areata in children. A total of 9 children with 30 recalcitrant patches alopecia areata and two children with alopecia areata totalis were enrolled in this study which included seven male and four female patients, aged between 4 and 14 years and the durations of their disease were between 7 and 25 months. All of these patients had more than one lesion of alopecia areata and at least one of them was left as a control for comparison. The lesions were treated with the 308-nm Excimer laser twice a week for a period of 12 weeks. Regrowth of hair was observed in 18 (60%) alopecia patches in the scalp, while there was no response in the control patches and over the extremities. Only four patients with scalp lesions showed a recurrence of alopecia after 6 months post laser therapy. So, 308-nm Excimer laser is considered an effective safe therapeutic option for patchy alopecia areata in children.

Age-dependent associations between androgenetic alopecia and prostate cancer risk.

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Muller, David C; Giles, Graham G; Sinclair, Rod; Hopper, John L; English, Dallas R; Severi, Gianluca

2013-02-01

Both prostate cancer and androgenetic alopecia are strongly age-related conditions that are considered to be androgen dependent, but studies of the relationship between them have yielded inconsistent results. We aimed to assess whether androgenetic alopecia at ages 20 and 40 years are associated with risk of prostate cancer. At a follow-up of the Melbourne Collaborative Cohort Study, men were asked to assess their hair pattern at ages 20 and 40 years relative to eight categories in showcards. Cases were men notified to the Victorian Cancer Registry with prostate cancer diagnosed between cohort enrollment (1990-1994) and follow-up attendance (2003-2009). Flexible parametric survival models were used to estimate age-varying HRs and predicted cumulative probabilities of prostate cancer by androgenetic alopecia categories. Of 9,448 men that attended follow-up and provided data on androgenetic alopecia, we identified 476 prostate cancer cases during a median follow-up of 11 years four months. Cumulative probability of prostate cancer was greater at all ages up to 76 years, for men with vertex versus no androgenetic alopecia at age of 40 years. At age of 76 years, the estimated probabilities converged to 0.15. Vertex androgenetic alopecia at 40 years was also associated with younger age of diagnosis for prostate cancer cases. Vertex androgenetic alopecia at age of 40 years might be a marker of increased risk of early-onset prostate cancer. If confirmed, these results suggest that the apparently conflicting findings of previous studies might be explained by failure to adequately model the age-varying nature of the association between androgenetic alopecia and prostate cancer.

308-nm excimer laser for the treatment of alopecia areata.

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Al-Mutairi, Nawaf

2007-12-01

Alopecia areata is loss of hair from localized or diffuse areas of hair-bearing area of the skin. Recently there are reports of efficacy of the 308-nm excimer radiation for this condition. To study the effect of the 308-nm excimer laser in the treatment of alopecia areata. Eighteen patients with 42 recalcitrant patches (including 1 adult with alopecia totalis) were enrolled in this study. The lesions were treated with the 308-nm excimer laser twice a week for a period of 12 weeks; one lesion on each patient was left as a control for comparison. There were 7 males and 11 females in this study. Regrowth of hair was observed in 17 (41.5%) patches. Thirteen of the 18 lesions in scalp showed a complete regrowth of hair. The extremity regions failed to show a response. Atopic diatheses had an unfavorable effect on the outcome in our patients. The 308-nm excimer laser is an effective therapeutic option for patchy alopecia areata of the scalp and for some cases with patchy alopecia areata of the beard area. It does not work for patchy alopecia areata of the extremities.

Transient Efficacy of Tofacitinib in Alopecia Areata Universalis

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Florian Anzengruber

2016-04-01

Full Text Available Alopecia areata is a common autoimmune disorder that targets hair follicles. Swarms of lymphocytes surround the basis of the follicles, inducing loss of pigmented terminal hair and subsequently inhibit further hair growth. Depending on the extent of involvement, alopecia areata can be associated with a dramatic reduction of quality of life. Currently, no targeted treatment option is available, and topical immune therapies or immunosuppressive drugs are typically used with mixed success. Recently, several cases of alopecia areata responding to Janus kinase inhibitors were published. Here, we report on a businessman with alopecia areata universalis who was treated with tofacitinib. We observed initial signs of hair regrowth in the same timeframe as previously reported, but efficacy quickly waned again, leading to renewed effluvium. Thus, even though tofacitinib and ruxolitinib are a promising new treatment option, we have yet to learn more about their potential role in each particular patient's individual treatment strategy.

Hair Mesotherapy in Treatment of Alopecia

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Selcuk Ozdogan

2011-01-01

mesotherapy in any form. Material and Methods: In this study, we evaluate the clinical changes of mesotherapy formulation on 15 men and 8 women patients, which consists of minoxidil, biotin, dexpantenol, herbal complex and procain and which is applied for androgenetic alopecia in our clinic every week. Results: In the analysis done before and after the mesotherapy, when the hair quantity, hair thickness, scalp state and hair loss are compared, the difference between them was statistically meaningful (p<0,05. There was no side effect during and after the application. Conclusion: In the hair mesotherapy, there is lack of mixture and application scheme whose effectiveness has been proved scientifically. We approve this study to be published that it supports the few  issues.

Frontal fibrosing alopecia treatment options.

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Fertig, Raymond; Tosti, Antonella

2016-11-01

Frontal fibrosing alopecia (FFA) is a rare dermatologic disease that causes scarring and hair loss and is increasing in prevalence worldwide. FFA patients typically present with hair loss in the frontal scalp region and eyebrows which may be associated with sensations of itching or burning. FFA is a clinically distinct variant of lichen planopilaris (LPP) that affects predominantly postmenopausal women, although men and premenopausal women may also be affected. Early diagnosis and prompt treatment are necessary to prevent definitive scarring and permanent hair loss. Data from retrospective studies indicate that 5-alpha-reductase inhibitors (5aRIs) are effective in stabilizing the disease. In our clinical experience, we have seen optimal results treating FFA patients with oral finasteride in conjunction with hydroxychloroquine, topical calcineurin inhibitors (tacrolimus) and excimer laser in patients with signs of active inflammation.

Alopecia areata.

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Hon, Kam-Lun E; Leung, Alexander K C

2011-05-01

Alopecia aerata (AA) is an autoimmune disease that presents as well defined patches of nonscarring hair loss with no overt epidermal changes. The life-time risk of AA in the general population is approximately 1.7%. As many as 60% of patients with AA have disease onset before 20 years of age. AA most commonly manifests as sudden loss of hair in well demarcated, localized area in the scalp. The hair loss is usually limited to a single patch. The lesion is usually round or oval. "Exclamation point hairs" are frequently seen at the periphery of the lesion. Because of the high rate of spontaneous recovery especially in those with small areas of hair loss or with a recent onset, not all patients require pharmacological treatment. A "watch-and-wait" approach is often recommended. Psychological support may be offered if necessary. For patients who actively desire treatment, topical corticosteroids and/or minoxidil are the treatment of choice. Interleukin (IL)-31 antibodies and 308-nm Excimer laser as novel treatment modalities appear promising in the armamentarium against this distressing disease. The review also outlined recent patents on the treatment of alopecia.

Exacerbation of alopecia areata: A possible complication of sodium tetradecyl sulphate foam sclerotherapy treatment for varicose veins

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Whiteley, Mark S; Smith, Victoria C

2017-01-01

A 40-year-old woman with a history of alopecia areata related to stress or hormonal changes was treated for bilateral primary symptomatic varicose veins (CEAP clinical score C2S) of pelvic origin, using a staged procedure. Her first procedure entailed pelvic vein embolisation of three pelvic veins using 14 coils and including foam sclerotherapy of the tributaries, using 3% sodium tetradecyl sulphate. Following this procedure, she had an exacerbation of alopecia areata with some moderate shedd...

Alopecia universalis, renal stones, and hyperuricemia: A familial or an unfamiliar association

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Kalachand Jana

2014-01-01

Full Text Available Alopecia Universalis is an autoimmune disorder which sometimes may be associated with other autoimmune diseases like vitiligo, atopic dermatitis and endocrine disorders like hypothyroidism. In less than 2% of cases it may be associated with nephrotic syndrome although the underlying etiology has not been reported. We report here one similar case that had alopecia universalis beginning at the age of 17 years and simultaneously developed hyperuricemia. His son also developed alopecia universalis and renal stones at an early age of 10 years. The case represents one of the rare forms of alopecia namely alopecia universalis in two generations of the same family. Apart from this the case highlights the presence of renal stones probably due to hyperuricemia in both the generations which invokes a need to investigate any association of hyperuricemia with alopecia universalis.

The Role of Vitamin D in Non-Scarring Alopecia

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Agnieszka Gerkowicz

2017-12-01

Full Text Available Non-scarring hair loss is a common problem that affects both male and female patients. Since any disturbances in the hair follicle cycle may lead to hair shedding, or alopecia, it is not surprising that the possible role of vitamin D in alopecia was investigated in many studies. Vitamin D has been shown to have many important functions. A growing body of evidence shows that vitamin D and its receptor are responsible for maintaining not only calcium homeostasis but also skin homeostasis. Moreover, vitamin D could also regulate cutaneous innate and adaptive immunity. This paper presents a review of current literature considering the role of vitamin D in alopecia areata, telogen effluvium, and female pattern hair loss. The majority of studies revealed decreased serum 25-hydroxyvitamin D levels in patients with different types of non-scarring alopecia, which could suggest its potential role in the pathogenesis of hair loss. According to the authors, vitamin D supplementation could be a therapeutic option for patients with alopecia areata, female pattern hair loss, or telogen effluvium. However, further studies on a larger group of patients are required.

UV laser-induced fluorescence spectroscopy and laser Doppler flowmetry in the diagnostics of alopecia

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Skomorokha, Diana P.; Pigoreva, Yulia N.; Salmin, Vladimir V.

2016-04-01

Development of optical biopsy methods has a great interest for medical diagnostics. In clinical and experimental studies it is very important to analyze blood circulation quickly and accurately, thereby laser Doppler flowmetry (LDF) is widely used. UV laser-induced fluorescence spectroscopy (UV LIFS) is express highly sensitive and widely-spread method with no destructive impact, high excitation selectivity and the possibility to use in highly scattering media. The goal of this work was to assess a correlation of UV laser-induced fluorescence spectroscopy and laser Doppler flowmetry parameters, and a possibility to identify or to differentiate various types of pathological changes in tissues according to their autofluorescence spectra. Three groups of patients with diffuse (symptomatic) alopecia, androgenic alopecia, and focal alopecia have been tested. Each groups consisted of not less than 20 persons. The measurements have been done in the parietal and occipital regions of the sculls. We used the original automated spectrofluorimeter to record autofluorescence spectra, and standard laser Doppler flowmeter BLF-21 (Transonic Systems, Inc., USA) to analyze the basal levels of blood circulation. Our results show that UV LIFS accurately distinguishes the zones with different types of alopecia. We found high correlation of the basal levels of blood circulation and the integrated intensity of autofluorescence in the affected tissue.

Theory and practice of clinical ethics support services: narrative and hermeneutical perspectives

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Porz, R.; Landeweer, E.G.M.; Widdershoven, G.A.M.

2011-01-01

In this paper we introduce narrative and hermeneutical perspectives to clinical ethics support services (CESS). We propose a threefold consideration of 'theory' and show how it is interwoven with 'practice' as we go along. First, we look at theory in its foundational role: in our case 'narrative

Comparing the therapeutic effects of finasteride gel and tablet in treatment of the androgenetic alopecia

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Hajheydari Zohreh

2009-01-01

Full Text Available Background: Finasteride, a type P-selective 5a-reductase inhibitor, as a causative agent of decreasing dihydroxy testestrone (DHT level, is effective in the treatment of male androgenic alopecia. Aim: We compared the local and oral finasteride in the treatment of androgenic alopecia. Method: This is a double blind, randomized clinical trial study of 45 male patients, who were referred with alopecia to the private clinics and departments in Boo-Ali Sina Hospital, in Sari. Patients with male androgenic alopecia were selected according to the history and physical examinations. The patients were randomly divided into two: topical finasteride (A and oral finasteride (B groups. Topical finasteride group (A received a topical gel of 1% finasteride and placebo tablets, while the oral finasteride group (B received finasteride tablets (1 mg and gel base (without drug as placebo for 6 months. The patients were followed by clinical observation and recording of side effects prior to the treatment and at the end of first week, and then by a monthly follow-up. The size of bald area, total hair count, and terminal hair were studied. Data were analyzed by descriptive and Chi-square statistical test. Results: The mean duration of hair loss was 18.8±23.10 months. Each month the terminal hair, size of bald area and hair count between the two groups were compared. There were no significant differences between the two groups as a viewpoint of hair thickness, hair counts and the size of bald area. Serial measurements indicated a significant increase in hair counts and terminal hair counts between the two groups. Conclusions: The results of this study showed that the therapeutic effects of both finasteride gel and finasteride tablet were relatively similar to each other.

Estudo do manejo do estresse em pacientes acometidos por alopecia areata Estudio del manejo del estrés en pacientes acometidos por alopecia areata A study of stress management in patients stricken by alopecia areata

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Simone Maria Godinho

2009-03-01

Full Text Available Alopecia Areata é uma dermatose caracterizada pela perda repentina de pêlos em uma única ou em várias áreas, na forma de círculo. Normalmente a perda se inicia no couro cabeludo, podendo também ocorrer em outras partes do corpo. Fatores emocionais traumáticos são referidos como desencadeantes. Um grupo de 12 pacientes acometidos de alopecia areata foi avaliado por meio de entrevista psicológica e do método de Rorschach (Sistema Compreensivo por Exner, com vista a identificar as condições de personalidade dos pacientes no que se refere ao manejo do estresse. Todos os pacientes relataram episódios traumáticos em suas vidas que poderiam ser considerados como desencadeantes da doença, e nove apresentaram nítidas dificuldades no controle e manejo do estresse.Alopecia Areata es una dermatosis caracterizada por la pierda de pelos, de forma rápida y en áreas. La pierda ocurre normalmente en los cabellos, como también en partes del cuerpo. Factores emocionales traumáticos son referidos como desencadenantes. Un grupo de 12 pacientes acometidos de alopecia areata fue evaluado por medio de entrevista psicológica y método de Rorschach (Sistema Comprensivo por Exner, pretendiendo un estudio exploratorio de la dinámica emocional y de la influencia de los factores psicológicos en la etiología de la alopecia areata. Todos los pacientes relataron episodios traumáticos en sus vidas que podrían ser considerados como desencadenantes de la enfermedad, y nueve presentaron nítidas dificultades en el control y manejo del estrés.Alopecia areata is a common dermatological disorder characterized by the rapid loss of hair in single or multiple patches. Hair loss is often on the scalp, but can also occur in other areas of the body. Psychological traumas have often been cited as precipitating factors. An evaluation of a group of twelve patients diagnosed with alopecia areata was undertaken using psychological interviews and the Rorschach Test

Alopecia: manifestação cutânea rara de sarcoidose Alopecia: an uncommon cutaneous manifestation of sarcoidosis

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Fabiane Mulinari Brenner

2008-10-01

Full Text Available A sarcoidose é doença granulomatosa multissistêmica que geralmente compromete o trato respiratório e os linfonodos hilares. A pele é comumente afetada, mas raramente o couro cabeludo. Dois casos de sarcoidose com lesões no couro cabeludo são relatados: o primeiro, em paciente negra apresentando áreas de alopecia no couro cabeludo associada a outras lesões cutâneas; e o segundo, em paciente branca, portadora de sarcoidose pulmonar, com alopecia como manifestação cutânea isolada. A sarcoidose de couro cabeludo merece especial atenção, pois nos pacientes com essa forma de lesão cutânea existe alta incidência de acometimento sistêmico.Sarcoidosis is a multi-system granulomatous disease that generally affects the respiratory tract and hilar lymph nodes. The skin is also commonly involved, although cutaneous sarcoidosis on the scalp is rare. Two cases of scalp sarcoidosis are reported: the first presented with patchy alopecia, cutaneous sarcoidosis and also systemic disease in a black patient; the second case is related to an uncommon presentation with alopecia as the single cutaneous manifestation in a Caucasian patient with pulmonary sarcoidosis. Scalp sarcoidosis deserves special attention because there is a high incidence of other systemic lesions with this cutaneous manifestation, thus a careful investigation should be performed in these patients.

Nail Involvement in Alopecia Areata: A Questionnaire-based Survey on Clinical Signs, Impact on Quality of Life and Review of the Literature

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Yvonne B.M. Roest

2017-10-01

Full Text Available Alopecia areata (AA is an immune-mediated disease causing temporary or permanent hair loss. Up to 46% of patients with AA also have nail involvement. The aim of this study was to determine the presence, types, and clinical implications of nail changes in patients with AA. This questionnaire-based survey evaluated 256 patients with AA. General demographic variables, specific nail changes, nail-related quality of life (QoL, and treatment history and need were evaluated. Prevalence of nail involvement in AA was 64.1%. The specific nail signs reported most frequently were pitting (29.7%, p = 0.008 and trachyonychia (18.0%. Red spots on the lunula were less frequent (5.1%, but very specific for severe AA. Nail-related QoL was only minimally affected by nail changes. In conclusion, nail involvement is common in patients with AA and presents mostly with pitting and trachyonychia. The presence of these nail changes reflects the severity of the disease, with red spots on the lunula as a predictor for severe alopecia

Effect of a Scalp Cooling Device on Alopecia in Women Undergoing Chemotherapy for Breast Cancer: The SCALP Randomized Clinical Trial.

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Nangia, Julie; Wang, Tao; Osborne, Cynthia; Niravath, Polly; Otte, Kristen; Papish, Steven; Holmes, Frankie; Abraham, Jame; Lacouture, Mario; Courtright, Jay; Paxman, Richard; Rude, Mari; Hilsenbeck, Susan; Osborne, C Kent; Rimawi, Mothaffar

2017-02-14

Chemotherapy may induce alopecia. Although scalp cooling devices have been used to prevent this alopecia, efficacy has not been assessed in a randomized clinical trial. To assess whether a scalp cooling device is effective at reducing chemotherapy-induced alopecia and to assess adverse treatment effects. Multicenter randomized clinical trial of women with breast cancer undergoing chemotherapy. Patients were enrolled from December 9, 2013, to September 30, 2016. One interim analysis was planned to allow the study to stop early for efficacy. Data reported are from the interim analysis. This study was conducted at 7 sites in the United States, and 182 women with breast cancer requiring chemotherapy were enrolled and randomized. Participants were randomized to scalp cooling (n = 119) or control (n = 63). Scalp cooling was done using a scalp cooling device. The primary efficacy end points were successful hair preservation assessed using the Common Terminology Criteria for Adverse Events version 4.0 scale (grade 0 [no hair loss] or grade 1 [Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, Hospital Anxiety and Depression Scale, and a summary scale of the Body Image Scale. At the time of the interim analysis, 142 participants were evaluable. The mean (SD) age of the patients was 52.6 (10.1) years; 36% (n = 51) received anthracycline-based chemotherapy and 64% (n = 91) received taxane-based chemotherapy. Successful hair preservation was found in 48 of 95 women with cooling (50.5%; 95% CI, 40.7%-60.4%) compared with 0 of 47 women in the control group (0%; 95% CI, 0%-7.6%) (success rate difference, 50.5%; 95% CI, 40.5%-60.6%). Because the 1-tailed P value from the Fisher exact test was women with stage I to II breast cancer receiving chemotherapy with a taxane, anthracycline, or both, those who underwent scalp cooling were significantly more likely to have less than 50% hair loss after the fourth chemotherapy cycle

Serum and tissue angiotensin-converting enzyme in patients with alopecia areata.

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Fahim, Shabnam; Montazer, Fatemeh; Tohidinik, Hamid Reza; Naraghi, Zahra Safaei; Abedini, Robabeh; Nasimi, Maryam; Ghandi, Narges

2018-03-27

Alopecia areata is an immune-dependent disorder characterized by the interaction of T-lymphocytes with follicular antigens. Recent studies have shown the existence of a local renin-angiotensin system in the skin, where angiotensin-converting enzyme (ACE) plays a role in autoimmunity and inflammation. The objective of this study was to evaluate serum and tissue ACE activity in patients with alopecia areata. This case-control study was conducted on patients with alopecia areata and healthy controls. Serum and tissue ACE activity were assessed and compared between the two groups. Twenty-five alopecia areata patients (60% male, mean age 32.1 ± 9.9 years) and 24 controls (50% male, mean age 37.4 ± 8.8 years) were included. Mean serum ACE activity was 52.1 ± 9 U/L in cases and 55.3 ± 14.7 U/L in controls (P = 0.37). Tissue ACE activity was significantly lower in cases in all parts of the skin i.e. epidermis (P = 0.016), follicular epithelium (P = 0.004), and endothelium (P = 0.037). Among cases, serum ACE activity was significantly higher in patients with more severe disease (P = 0.030), nonpatchy alopecia areata (alopecia universalis; ophiasis, patchy and ophiasis, diffuse) (P = 0.029), and with nail involvement (P = 0.027). The sample size was too small to draw definite conclusions. Further, most of the patients had only mild or moderate alopecia areata. Unlike in some other inflammatory diseases, the tissue level of ACE seems to be significantly lower in alopecia areata compared to normal controls. Serum ACE was significantly higher in patients with more severe disease.

VIEWPOINT – Vitiligo and alopecia areata: Apples and oranges?

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Harris, John E.

2013-01-01

Vitiligo and alopecia areata are common autoimmune diseases of the skin. Vitiligo is caused by the destruction of melanocytes and results in the appearance of white patches on any part of the body, while alopecia areata is characterized by patchy hair loss primarily on the scalp, but may also involve other areas as well. At first glance, the two diseases appear to be quite different, targeting different cell types and managed using different treatment approaches. However, the immune cell populations and cytokines that drive each disease are similar, they are closely associated within patients and their family members, and vitiligo and alopecia areata have common genetic risk factors, suggesting that they share a similar pathogenesis. Like apples and oranges, vitiligo and alopecia areata have some obvious differences, but similarities abound. Recognizing both similarities and differences will promote research into the pathogenesis of each disease, as well as the development of new treatments. PMID:24131336

Review of quality of life studies in women with alopecia

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D.S. Davis, MD, MS

2018-03-01

Full Text Available Alopecia is a dermatologic condition that affects the pilosebaceous unit in both men and women. In addition to a thorough medical history and physical examination, a host of diagnostic tools may be warranted to differentiate nonscarring and scarring alopecias. Female pattern hair loss represents the most common form of hair loss experienced by up to 40% of women by a certain age. Although alopecia is a benign disorder, even the most negligible amount of hair loss can be devastating to a patient’s self-esteem, self-image, and overall quality of life. We present this comprehensive review of quality of life studies in women with alopecia to describe the multitude of feelings and emotions associated with the disorder and remind dermatologists of the psychological impact it can have on women.

Alopecia areata - pattern in industrial city of Baroda

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Jain S

2003-03-01

Full Text Available Department of Dermatology, Venereology and Leprology, S.S.G. Hospital, Baroda. The profile of Alopecia areata (AA was studied in 150 subjects in industrial city of Baroda, alopecia areata is the problem of young males as 52.1 %patients are in 2-39 years age group and male to female ratio being 1.7: 1. Most of alopecia areata presents within 6 month of onset. The problem of AA is of cosmetic significance. AA pattern is the commonest and only few have combined AA and ophiasis. The common site is scalp (parietal, occipital, frontal followed by beard and moustache. Associated atopic state is not common hence indicating good prognosis. Nail involvement though not common but is in form of pitting.

Evaluation of permanent alopecia in pediatric medulloblastoma patients treated with proton radiation

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Min, Chul Hee; Paganetti, Harald; Winey, Brian A; Adams, Judith; MacDonald, Shannon M; Tarbell, Nancy J; Yock, Torunn I

2014-01-01

To precisely calculate skin dose and thus to evaluate the relationship between the skin dose and permanent alopecia for pediatric medulloblastoma patients treated with proton beams. The dosimetry and alopecia outcomes of 12 children with medulloblastoma (ages 4-15 years) comprise the study cohort. Permanent alopecia was assessed and graded after completion of the entire therapy. Skin threshold doses of permanent alopecia were calculated based on the skin dose from the craniospinal irradiation (CSI) plan using the concept of generalized equivalent uniform dose (gEUD) and accounting for chemotherapy intensity. Monte Carlo simulations were employed to accurately assess uncertainties due to beam range prediction and secondary particles. Increasing the dose of the CSI field or the dose given by the boost field to the posterior fossa increased total skin dose delivered in that region. It was found that permanent alopecia could be correlated with CSI dose with a threshold of about 21 Gy (relative biological effectiveness, RBE) with high dose chemotherapy and 30 Gy (RBE) with conventional chemotherapy. Our results based on 12 patients provide a relationship between the skin dose and permanent alopecia for pediatric medulloblastoma patients treated with protons. The alopecia risk as assessed with gEUD could be predicted based on the treatment plan information

Minoxidil (Mx) as a prophylaxis of doxorubicin--induced alopecia.

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Rodriguez, R; Machiavelli, M; Leone, B; Romero, A; Cuevas, M A; Langhi, M; Romero Acuña, L; Romero Acuña, J; Amato, S; Barbieri, M

1994-10-01

Minoxidil (Mx) is known to induce hair growth in men with male-pattern baldness. Based on this potential, the effectiveness of Mx 2% topical solution was evaluated in cancer patients (pts) to prevent doxorubicin-induced alopecia. 48 female pts with different types of solid tumors treated with doxorubicin-based chemotherapy in a dose range of 50-60 mg/m2/cycle were randomly assigned to receive Mx 2% topical solution or placebo. 88% and 92% of pts in both arms showed severe alopecia (p = ns). No adverse effects were observed. In this study Mx 2% topical solution was non-toxic but was not effective in the prevention of chemotherapy-induced alopecia.

Evaluating Platelet-Rich Therapy for Facial Aesthetics and Alopecia: A Critical Review of the Literature.

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Motosk O, Catherine C; Khouri, Kimberly S; Poudrier, Grace; Sinno, Sammy; Hazen, Alexes

2018-05-01

Despite the growing popularity of platelet-rich plasma, existing evidence supporting its efficacy remains controversial due to the lack of large-scale studies and standardized protocols for preparation and application. This article reviews its use in facial rejuvenation, fat grafting, acne scarring, and androgenic alopecia. Emphasis is placed on comparing methods of platelet-rich plasma preparation and application across studies. A systematic review was performed for articles published between 2006 and 2015. All clinical studies and case reports that addressed platelet-rich plasma alone and/or in combination with fat grafting for facial rejuvenation, acne scarring, or androgenic alopecia were included. Of the 22 articles included in the analysis, seven studies used platelet-rich plasma alone for facial rejuvenation, seven in combination with fat grafting, two for treatment of acne scarring, and six for treatment of androgenic alopecia. Individual study procedures, means of evaluation, and significant results are summarized. Although the majority of studies in this review report positive results, significant variation exists in preparation protocols and in the number and frequency of clinical treatments. The majority of studies report positive results for all indications evaluated in this review, but the procedure is limited by the lack of a standardized method for preparation and application of platelet-rich plasma. The extent to which significant variability in platelet-rich plasma preparation and/or application methods may affect clinical outcomes is not completely clear. In the interim, we present a consolidation of platelet-rich plasma treatment techniques and outcomes currently in use to help guide physicians in their clinical practice.

Melatonin increases anagen hair rate in women with androgenetic alopecia or diffuse alopecia: results of a pilot randomized controlled trial.

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Fischer, T W; Burmeister, G; Schmidt, H W; Elsner, P

2004-02-01

In addition to the well-known hormonal influences of testosterone and dihydrotestosterone on the hair cycle, melatonin has been reported to have a beneficial effect on hair growth in animals. The effect of melatonin on hair growth in humans has not been investigated so far. To examine whether topically applied melatonin influences anagen and telogen hair rate in women with androgenetic or diffuse hair loss. A double-blind, randomized, placebo-controlled study was conducted in 40 women suffering from diffuse alopecia or androgenetic alopecia. A 0.1% melatonin or a placebo solution was applied on the scalp once daily for 6 months and trichograms were performed to assess anagen and telogen hair rate. To monitor effects of treatment on physiological melatonin levels, blood samples were taken over the whole study period. Melatonin led to a significantly increased anagen hair rate in occipital hair in women with androgenetic hair loss compared with placebo (n=12; P=0.012). For frontal hair, melatonin gave a significant increase in the group with diffuse alopecia (n=28; P=0.046). The occipital hair samples of patients with diffuse alopecia and the frontal hair counts of those with androgenetic alopecia also showed an increase of anagen hair, but differences were not significant. Plasma melatonin levels increased under treatment with melatonin, but did not exceed the physiological night peak. To the authors' knowledge, this pilot study is the first to show that topically applied melatonin might influence hair growth in humans in vivo. The mode of action is not known, but the effect might result from an induction of anagen phase.

Stem cell markers (cytokeratin 17 and cytokeratin 19 in scarring and nonscarring alopecia

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Dalia El Sakka

2016-01-01

Full Text Available Background: Alopecia is one of the most important hair follicle (HF disorders, which is divided into scarring (cicatricial and nonscarring (noncicatricial types. Objective: The aim of this study is to investigate the expression of stem cell (SC markers such as cytokeratin (CK 17 and CK19 in scarring and nonscarring alopecia. Materials and Methods: Thirty patients with scalp alopecia (15 with scarring alopecia and 15 without together with ten healthy volunteers were included in this study. Biopsies were taken from all participants and stained for CK17 and CK19 using immunohistochemistry. Results: There was a statistically significant difference between the nonscarring group and the control group with regard to CK17 expression in the outer layers of the HFs (P = 0.00 and CK19 staining of the inner layers of the HFs (P = 0.008. There was a statistically significant difference between the scarring and the control groups regarding CK17 expression in the outer (P = 0.00 and the inner layers (P = 0.00 of the HFs and CK19 expression in the inner layers of the HFs (P = 0.00. CK17 expression in the outer layers (P = 0.02 and the inner layers of the HFs (P = 0.00 together with CK19 expression in the inner layers of the HFs (P = 0.00 showed statistically significant differences between scarring and nonscarring alopecia groups. Conclusions: The presence of SC markers (CK17 and CK19 in the HFs was affected in both scarring and nonscarring alopecia, but the defect in scarring alopecia is more evident than that of nonscarring alopecia. The persistence of SC markers in some types of scarring alopecia could give a hope for the recovery of these lesions. Further studies are recommended to clarify the benefit from using HF SCs in the treatment of alopecia.

Stem Cell Markers (Cytokeratin 17 and Cytokeratin 19) in Scarring and Nonscarring Alopecia

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El Sakka, Dalia; Gaber, Mohamed Abdel Wahed; Abdou, Asmaa Gaber; Wahed, Moshira Abdel; Saleh, Ahmed Abdel-Wahab; Shehata, Walla

2016-01-01

Background: Alopecia is one of the most important hair follicle (HF) disorders, which is divided into scarring (cicatricial) and nonscarring (noncicatricial) types. Objective: The aim of this study is to investigate the expression of stem cell (SC) markers such as cytokeratin (CK) 17 and CK19 in scarring and nonscarring alopecia. Materials and Methods: Thirty patients with scalp alopecia (15 with scarring alopecia and 15 without) together with ten healthy volunteers were included in this study. Biopsies were taken from all participants and stained for CK17 and CK19 using immunohistochemistry. Results: There was a statistically significant difference between the nonscarring group and the control group with regard to CK17 expression in the outer layers of the HFs (P = 0.00) and CK19 staining of the inner layers of the HFs (P = 0.008). There was a statistically significant difference between the scarring and the control groups regarding CK17 expression in the outer (P = 0.00) and the inner layers (P = 0.00) of the HFs and CK19 expression in the inner layers of the HFs (P = 0.00). CK17 expression in the outer layers (P = 0.02) and the inner layers of the HFs (P = 0.00) together with CK19 expression in the inner layers of the HFs (P = 0.00) showed statistically significant differences between scarring and nonscarring alopecia groups. Conclusions: The presence of SC markers (CK17 and CK19) in the HFs was affected in both scarring and nonscarring alopecia, but the defect in scarring alopecia is more evident than that of nonscarring alopecia. The persistence of SC markers in some types of scarring alopecia could give a hope for the recovery of these lesions. Further studies are recommended to clarify the benefit from using HF SCs in the treatment of alopecia. PMID:27761086

Vertical vs. transverse sections of scalp biopsy specimens: a pilot study on the comparison of the diagnostic value of two techniques in alopecia.

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Özcan, D; Özen, Ö; Seçkin, D

2011-12-01

Using both vertical and transverse sections is preferred for histopathological diagnosis of alopecia. However, in cases in which only a single biopsy is taken, it is not clear which type of sectioning is better. To compare the diagnostic value of transverse and vertical sections. In total, 53 patients with alopecia were enrolled in the study. Two biopsies were taken from each patient, and cut into either transverse or vertical sections. The clinical and histopathological findings were evaluated together for the definitive diagnosis. After the study period, a pathologist randomly re-evaluated the sections. We compared the histopathological diagnoses with the definitive diagnoses, and determined the sensitivity and specificity of each method. A definitive diagnosis was made for 47 patients (88.7%). Of these, 30 (63.8%) had noncicatricial and 17 (36.2%) had cicatricial alopecia, and the diagnosis was made by transverse and vertical sections for 43 (91.5%) and 39 (88%), respectively (P > 0.05; sensitivity; 91.5% vs. 82%). All 30 patients with noncicatricial alopecia were diagnosed by transverse sections, and 25 (83.3%) of the 30 were diagnosed with vertical sections (P = 0.05; sensitivity 100% vs. 83.3%). Of the 17 patients with cicatricial alopecia, 13 (76.5%) and 14 (82.4%) patients were diagnosed by transverse and vertical sections, respectively (P > 0.05; sensitivity 76.5% vs. 82.4%). Five patients with lichen planopilaris were diagnosed by vertical sections, and one by transverse sections. There were several limitations to the study: (i) statistical subtype analysis could be performed only for alopecia areata; (ii) no conclusion could be drawn about the interobserver reliability of two sections; and (iii) having the pathologist-blinded study performed retrospectively might have caused a recall bias. If only a single biopsy specimen is available, it may be preferable to have transverse sections in cases of suspected noncicatricial alopecia, and vertical sections in

An analysis of narratives to identify critical thinking contexts in psychiatric clinical practice.

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Mun, Mi Suk

2010-02-01

The development of students' critical thinking abilities is one of the greatest challenges facing contemporary nursing educators. Nursing educators should know about what kind of contents or situations need critical thinking. The research was undertaken to identify the critical thinking contexts that nursing students confront in psychiatric clinical practices. Students were asked to document their everyday experience. The narratives were analysed and interpreted from the philosophical notion of hermeneutics. Four themes emerged as critical thinking contexts: anxiety, conflict, hyper-awareness, dilemmas. Writing narratives appear to provide opportunities for reflection in addition to facilitating critical thinking and communicative skills in students. Also, for the instructor, students' clinical narratives could provide insight to understand how students are thinking and to share student's personal difficulties.

Tofacitinib for the treatment of alopecia areata and variants in adolescents.

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Craiglow, Brittany G; Liu, Lucy Y; King, Brett A

2017-01-01

There are no reliably effective therapies for alopecia areata (AA). We sought to evaluate the benefit and adverse effects of the Janus kinase 1/3 inhibitor, tofacitinib, in a series of adolescent patients with AA. We reviewed the records of 13 adolescent patients with AA treated with tofacitinib. Severity of disease was assessed using the Severity of Alopecia Tool (SALT). Adverse events were evaluated by laboratory monitoring, physical examinations, and review of systems. Thirteen patients, aged 12 to 17 years, with AA were treated with tofacitinib. Nine patients experienced clinically significant hair regrowth. Median percent change in SALT score was 93% (mean 61%; 1%-100%) at an average of 6.5 months of treatment. Adverse events were mild. Limitations include the retrospective nature of the data, small sample size, and lack of a control group. Tofacitinib is a promising therapy for AA in adolescents. The use of tofacitinib and other Janus kinase inhibitors for the treatment of AA in this age group should be further evaluated in prospective clinical trials. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Low-power laser use in the treatment of alopecia and crural ulcers

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Ciuchita, Tavi; Usurelu, Mircea; Antipa, Ciprian; Vlaiculescu, Mihaela; Ionescu, Elena

1998-07-01

The authors tried to verify the efficacy of Low Power Laser (LPL) in scalp alopecia and crural ulcers of different causes. Laser used was (red diode, continuous emission, 8 mW power, wave length 670 nm spot size about 5 mm diameter on some points 1 - 2 minutes per point. We also use as control classical therapy. Before, during and after treatment, histological samples were done for alopecia. For laser groups (alopecia and ulcers) the results were rather superior and in a three or twice time shorter than control group. We conclude that LPL therapy is a very useful complementary method for the treatment of scalp alopecia and crural ulcers.

Intravenous Dexamethasone Pulse Therapy For Extensive Alopecia Areata

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Thappa Devinder Mohan

1999-01-01

Full Text Available Patient with extensive alopecia areata (>30% scalp involvement were given 32mg of dexamethasone in 200 ml of 5% dextrose intravenously on three consecutive days (total 96mg every four weeks. Response was quantified as 1 to 25%, 25% to 50%, 50 to 75% and 75 to 100% of terminal hair growth by mapping and serial photographs. They were examined monthly for side effects of steroids. Six patients (5 male and 1 female with a mean age of 32 years were recruited. They had alopecia areata for a period ranging from 3 months to 2.5 years. All the six cases did not show further worsening of alopecia after 3 pulses. However, two of them showed less than 25% hair growth after 4 pulses and did not turn up for follow up. In 2 cases, 25 to 50% growth was observed an 50 to 75% growth was seen in 2 patients (one of them with ophiasic pattern after 6 pulses. The results were cosmetically acceptable for three of them. No adverse effect to steroids was encountered and the patients are still under follow up. The preliminary results show that dexamethasone pulse therapy is safe and effective for extensive alopecia areata.

STUDY OF THERAPEUTIC COMPARISON OF TACROLIMUS 0.1% AND MINOXIDIL 2% IN ALOPECIA AREATA

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Kallappa C. Herkal

2013-07-01

Full Text Available Introduction: Alopecia areata is a unique, idiopathic disease in which there is patchy hair loss. The variable and uncertain natural history of alopecia areata is accounting for the multiplicity of uncritical claims for a large variety of therapeutic procedures. Aim: to find the therapeutic comparison between tacrolimus 0.1% ointment and minoxidil 2% solution. Material and Methods: Patients attending skin out patient department in Navodaya medical college hospital and research centre, Raichur were screened and the consenting consecutive cases of Aopecia Areata (AA from December 2010 to November 2011 were chosen for study. There were 75 patients in the study. It is a randomized, single blind, intension to treat study. The eligible patients for the study were randomly allocated into two groups-Group A and Group B (38 in Group A and 37 in Group B. Patients in Group A were treated with 2% Minoxidi solution to be applied twice daily over the alopecia patch, where as Patients in Group B were treated with Tacrolimus 0.1% ointment applied twice daily. Patients were followed up at 2, 4, 6, 8, 10 and 12 weeks. Alopecia Grading Score (AGS was calculated at baseline and 12 weeks. Regrowth Score (RGS was calculated at 12 weeks. Results: Total 69 patients completed the study (35 in Group A and 34 in Group B. In our study RGS ≥ 3 was observed in 65.71% of patients treated with Tinoxidil 2% solution and 44.12% of patients treated with Tacrolimus 0.1% ointment. Conclusion: In our study Minoxidil 2% solution had better stimulatory effect on hair growth compared to Tacrolimus 0.1% ointment in the treatment of mild to moderate patchy alopecia areata. The combination treatment may yield a better clinical response than either of the agents used singly.

Efficacy of fractional lasers in treating alopecia: a literature review.

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Perper, Marina; Aldahan, Adam S; Fayne, Rachel A; Emerson, Christopher P; Nouri, Keyvan

2017-11-01

Hair loss stemming from different types of alopecia, such as androgenic alopecia and alopecia areata, negatively affects over half the population and, in many circumstances, causes serious psychosocial distress. Current treatment options for alopecia, such as minoxidil, anthralin, and intralesional corticosteroids, vary efficacy and side effect profiles. It is known that low-level laser/light therapies (LLLT), or photobiomodulations, such as the US FDA-cleared HairMax Lasercomb®, He-Ne laser, and excimer laser, are relatively affordable, user-friendly, safe, and effective forms of treatment for hair loss. While less is known about the effectiveness of fractional lasers for combating hair loss, research suggests that by creating microscopic thermal injury zones, fractional lasers may cause an increase in hair growth from a wound healing process, making them potential therapeutic options for alopecia. A literature review was performed to evaluate the effectiveness of fractional lasers on hair regrowth. The specific fractional laser therapies include the 1550-nm nonablative fractional erbium-glass laser, the ablative fractional 2940-nm erbium:YAG laser, and the ablative fractional CO 2 fractional laser. Additional randomized controlled trials are necessary to further evaluate the effectiveness of the lasers, as well as to establish appropriate parameters and treatment intervals.

Alopecia frontal fibrosante: una enfermedad en auge

OpenAIRE

Quintana-Sancho, A. de; Piris-García, X.; Valle-García, N.; Hierro-Cámara, M.

2016-01-01

La alopecia frontal fibrosante (AFF) es un tipo de alopecia cicatricial cuya incidencia está aumentando de forma significativa en nuestro país. Se caracteriza por un retroceso en la línea de implantación del pelo a nivel frontotemporal que afecta mayoritariamente a mujeres postmenopaúsicas, con un impacto negativo en su calidad de vida. Se asocia a menopausia precoz en un 14% de los casos y a hipotiroidismo en un 15%. Con respecto al tratamiento, son los inhibidores de la 5alfa-reductasa, los...

Alopecia with foreign body granulomas induced by Radiesse injection: A case report.

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Liu, Ren-Feng; Kuo, Tseng-Tong; Chao, Yen-Yu; Huang, Yu-Huei

2018-02-26

Radiesse is a soft tissue filler which has been widely used for cosmetic enhancement. The safety of Radiesse has been thoroughly investigated via numerous studies. A late-onset complication of Radiesse injection consists of foreign body granulomas, with only three case reports in over 10 years of clinical use. Herein, we describe the case of a patient who experienced alopecia with foreign body granulomas at the injection region one month after receiving a Radiesse injection. To our knowledge, this is the first report in the English literature of alopecia as an adverse event associated with Radiesse injection. The present case reminded physicians to evaluate more cautiously the necessity of injecting filler into hair-bearing area for lifting purpose. This procedure may cause foreign body granulomatous reaction, which may result in hair loss at the injection region.

Photobiomodulation therapy for androgenetic alopecia: A clinician's guide to home-use devices cleared by the Federal Drug Administration.

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Dodd, Erin M; Winter, Margo A; Hordinsky, Maria K; Sadick, Neil S; Farah, Ronda S

2018-06-01

The market for home-use photobiomodulation devices to treat androgenetic alopecia has rapidly expanded, and the Food and Drug Administration (FDA) has recently cleared many devices for this purpose. Patients increasingly seek the advice of dermatologists regarding the safety and efficacy of these hair loss treatments. The purpose of this guide was threefold: (1) to identify all home-use photobiomodulation therapy devices with FDA-clearance for treatment of androgenetic alopecia; (2) to review device design, features and existing clinical evidence; and (3) to discuss practical considerations of photobiomodulation therapy, including patient suitability, treatment goals, safety, and device selection. A search of the FDA 510(k) Premarket Notification database was conducted using product code "OAP" to identify all home-use devices that are FDA-cleared to treat androgenetic alopecia. Thirteen commercially available devices were identified and compared. Devices varied in shape, wavelength, light sources, technical features, price, and level of clinical evidence. To date, there are no head-to-head studies comparing the efficacy of these devices. Photobiomodulation therapy devices have an excellent safety profile and mounting evidence supporting their efficacy. However, long-term, high quality studies comparing these devices in diverse populations are lacking. As these devices become increasingly popular, dermatologists should be familiar with this treatment modality to add to their therapeutic armamentarium. AGA, androgenetic alopecia; FDA, Food and Drug Administration; IEC, International Electrotechnical Commission; LED, light-emitting diode; PBMT, photobiomodulation therapy.

INTRALESIONAL PLATELET RICH PLASMA vs INTRALESIONAL TRIAMCINOLONE IN THE TREATMENT OF ALOPECIA AREATA: A COMPARATIVE STUDY

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Shumez H, Prasad PVS, Kaviarasan PK, Deepika R

2015-01-01

Full Text Available Background: Alopecia areata (AA is a chronic non-scarring alopecia that involves the scalp and/or body, and is characterized by patchy areas of hair loss without any signs of clinical inflammation. Various therapies have been proposed for their treatment.But none have been shown to alter the course of the disease. Platelet Rich Plasma (PRP is a volume of autologous plasma that has a high platelet concentration. Growth factors released from platelets may act on stem cells in the bulge area of the follicles, stimulating the development of new follicles and promoting neovascularization. Aim: To evaluate and compare the efficacy of intralesional injection of autologous platelet rich plasma with intralesional injection of triamcinolone acetonide (10mg/ml in the treatment of alopecia areata. Methodology: 74 patients with alopecia areata were allocated into 2 groups and treated with triamcinolone and PRP injections. Treatment outcome was measured by taking into account extent and density of regrowth of hair and was expressed as a percentage of overall growth. Results: Forty eight patients were treated with triamcinolone injections and 26 patients were treated with PRP injections. Patients treated with PRP had an earlier response at the end of 6weeks than patients treated with triamcinolone. However, this difference was statistically insignificant. The overall improvement at the end of 9 weeks was 100% for all patients in both groups. Conclusion: PRP is a safe, simple, biocompatible and effective procedure for the treatment of alopecia areata with efficacy comparable with triamcinolone.

Low-level laser treatment accelerated hair regrowth in a rat model of chemotherapy-induced alopecia (CIA).

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Wikramanayake, Tongyu Cao; Villasante, Alexandra C; Mauro, Lucia M; Nouri, Keyvan; Schachner, Lawrence A; Perez, Carmen I; Jimenez, Joaquin J

2013-05-01

Chemotherapy-induced alopecia (CIA) is one of the most distressing side effects of antineoplastic chemotherapy for which there is no effective interventional approach. A low-level laser (LLL) device, the HairMax LaserComb®, has been cleared by the FDA to treat androgenetic alopecia. Its effects may be extended to other settings; we have demonstrated that LaserComb treatment induced hair regrowth in a mouse model for alopecia areata. In the current study, we tested whether LLL treatment could promote hair regrowth in a rat model for CIA. Chemotherapy agents cyclophosphamide, etoposide, or a combination of cyclophosphamide and doxorubicin were administered in young rats to induce alopecia, with or without LLL treatment. As expected, 7-10 days later, all the rats developed full body alopecia. However, rats receiving laser treatment regrew hair 5 days earlier than rats receiving chemotherapy alone or sham laser treatment (with the laser turned off). The accelerated hair regrowth in laser-treated rats was confirmed by histology. In addition, LLL treatment did not provide local protection to subcutaneously injected Shay chloroleukemic cells. Taken together, our results demonstrated that LLL treatment significantly accelerated hair regrowth after CIA without compromising the efficacy of chemotherapy in our rat model. Our results suggest that LLL should be explored for the treatment of CIA in clinical trials because LLL devices for home use (such as the HairMax LaserComb®) provide a user-friendly and noninvasive approach that could be translated to increased patient compliance and improved efficacy.

Side Effects: Hair Loss (Alopecia)

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Hair loss, also called alopecia, is a side effect of cancer treatments, such as chemotherapy and radiation therapy. Learn how to cope with and manage hair loss. Listen to tips from others who have experienced hair loss.

Er:YAG laser-assisted hair transplantation in cicatricial alopecia.

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Podda, M; Spieth, K; Kaufmann, R

2000-11-01

Autologous hair transplantation and its combination with flap or reduction procedures is a common surgical approach to cover defects in cicatricial alopecias. Due to the poor recipient conditions present in scar tissue, it is crucial to minimize the trauma exerted on implantation holes in order to achieve good transplantation results. We sought to evaluate the "cold"-ablative properties of the Er:YAG laser for the generation of recipient holes in cicatricial alopecia. Patients with cicatricial alopecia of diverse etiology were treated with Er:YAG laser-assisted hair transplantation. Mini- or micrografts were inserted into recipient holes ablated with a pulse energy of 900-1200 mJ and a spot size of 1.0-1.6 mm. A fluence of 80-120 J/cm2 and 8-12 pulses gave an almost ideal combination of minimal thermal damage and tissue ablation down to the subcutis. With an apparent mini- and micrograft survival of 95% we achieved good cosmetic results after two to five transplant sessions in all patients. The Er:YAG laser is a novel effective tool to ablate recipient holes for autologous hair transplantation in cicatricial alopecia.

[Female androgenetic alopecia, a survey of causes and therapeutic options].

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Duchková, Hana; Hašková, Marta

2015-01-01

Mesotherapy is one of the options for the treatment of androgenetic alopecia. Testing 24 women with androgenetic alopecia has demonstrated a positive effect of mesotherapy on the hair growth, hair thickness, with only insignificant increase of hair density. It is known that androgenetic alopecia represents a localized aging of hair follicles. We therefore decided to examine the different effects of mesotherapy on hair density in younger and in elderly women. In younger women mesotherapy significantly increased hair density compared with older women. For mesotherapy we used a combination of micronutrients and antioxidants. Mesotherapy achievements were evident for 6-12 months. Treatment requires a long-term care.

[Narrative-based medicine and clinical knowledge].

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Saito, Seiji

2006-01-01

Narrative Based Medicine (NBM) can be defined as follows; a) It views the patient's illness as an unfolding story within the wider story of the patient's life and life-world; b) It acknowledges the patient as the narrator of the story and the subject of the tale; c) It recognizes that all medical theories, hypothesis and pathophysiologies as socially constructed narratives and accepts the coexistence of multiple different narratives; d) It regards the emergence of new stories from dialogue and discourse between patients and healthcare professionals as part of the treatment. Because psychiatry is the only area of specialist medicine where talking and listening are explicitly understood to be therapeutic, NBM can be adopted an effective perspective and method in psychiatry.

Evaluation of the relationship between androgenetic alopecia and demodex infestation

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Zari Javidi

2008-01-01

Full Text Available Introduction: Androgenetic alopecia (AGA is one of the most common dermatologic disorders with a multifactorial etiology. Inflammatory activators such as Demodex infestation may play a role in the pathogenesis of some cases of androgenetic alopecia that do not respond to common treatments such as minoxidil and finasteride. The goal of this study is to evaluate the relationship between Demodex infestation and AGA. Materials and Methods: In this case-control study, 41 patients with AGA referred to the Dermatology Clinic of Imam Reza Hospital and 33 healthy individuals were evaluated as control. All of them were between 20 and 40 years old men. In order to identify Demodex infestation they were referred to the Parasitology laboratory. Results: Demodex was detected in 19.5% of patients and 15.2% of controls; therefore, there was no significant relationship between them statistically ( P = 0.0787. Most of patients (85.4% had greasy hair. The most common pattern of baldness was II degree in Hamilton scale. Conclusion: There is no relation between AGA and Demodex.

Identifying influenza-like illness presentation from unstructured general practice clinical narrative using a text classifier rule-based expert system versus a clinical expert.

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MacRae, Jayden; Love, Tom; Baker, Michael G; Dowell, Anthony; Carnachan, Matthew; Stubbe, Maria; McBain, Lynn

2015-10-06

We designed and validated a rule-based expert system to identify influenza like illness (ILI) from routinely recorded general practice clinical narrative to aid a larger retrospective research study into the impact of the 2009 influenza pandemic in New Zealand. Rules were assessed using pattern matching heuristics on routine clinical narrative. The system was trained using data from 623 clinical encounters and validated using a clinical expert as a gold standard against a mutually exclusive set of 901 records. We calculated a 98.2 % specificity and 90.2 % sensitivity across an ILI incidence of 12.4 % measured against clinical expert classification. Peak problem list identification of ILI by clinical coding in any month was 9.2 % of all detected ILI presentations. Our system addressed an unusual problem domain for clinical narrative classification; using notational, unstructured, clinician entered information in a community care setting. It performed well compared with other approaches and domains. It has potential applications in real-time surveillance of disease, and in assisted problem list coding for clinicians. Our system identified ILI presentation with sufficient accuracy for use at a population level in the wider research study. The peak coding of 9.2 % illustrated the need for automated coding of unstructured narrative in our study.

The role of vitamin D in alopecia areata

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Katarzyna M. Chyl-Surdacka

2016-05-01

Full Text Available Alopecia areata is an inflammatory disease with noncicatricial hair loss. Despite its high prevalence in the dermatological patient population, the pathogenesis is not sufficiently understood. In recent years, the contribution of autoimmune processes has been emphasized, as indicated by the presence of autoantibodies against hair follicle antigens and inflammatory cell infiltrates with increased expression of cytokines around the hair follicle. Vitamin D performs many important functions in the human body – is responsible for maintaining calcium homeostasis but is also an important regulator of the immune response. It acts mainly via the nuclear vitamin D receptor located on the surface of dendritic cells, macrophages, B and T cells, keratinocytes and cells of the hair follicle papillae. Vitamin D suppresses the immune system cells, and its deficiency may be important in pathophysiological phenomena in alopecia areata. According to current data, vitamin D supplementation may be a therapeutic option worth considering in patients with alopecia areata.

Comparison of thyroid function tests in alopecia totalis and universalis with control group

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Hassan Seirafi

2013-07-01

Full Text Available Background: Alopecia areata (AA is a common cause of noncicatricial alopecia that occurs as a patchy, confluent or diffuse pattern. Exact etiologic factor of AA not yet recognized. Among many hypothesis, relationship between AA and autoimmune disease, especially thyroid disorders, was more interesting. The objective of this study was to determine the prevalence of thyroid test disorders in the patients with alopecia totalis and universalis in comparison with normal population.Methods: We analyzed medical records of 100 patients, including 44 male and 56 female in Tehran Razi Hospital from 1388 to 1389. The mean age was 24.1 years. Patients having totalis and universalis form of AA considered as case group while 100 normal person (42 male and 58 female with mean age of 26.1 who had not any form of AA considered as control group. Both groups had not any sign of thyroid disease at clinical examination according to their available medical records. Collected data were analyzed statistically in SPSS software 17th version. Results: In the majority of patients (54% the disease was manifested in the first two decades of life. History of atopia was seen in 9.8% of patient. Presence of the similar disease in first-degree family members was seen in 14.3% of patients. Abnormal T3, T4 and TSH were significantly higher in case group. Abnormal T3 uptake was higher in case group but not statistically significant. Conclusion: Paraclinical thyroid disorders were significantly higher in the alopecia areata patients than in normal population. There was no significant association between the age, sex and duration of disease and presence thyroid dysfunction.

Normalization of relative and incomplete temporal expressions in clinical narratives.

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Sun, Weiyi; Rumshisky, Anna; Uzuner, Ozlem

2015-09-01

To improve the normalization of relative and incomplete temporal expressions (RI-TIMEXes) in clinical narratives. We analyzed the RI-TIMEXes in temporally annotated corpora and propose two hypotheses regarding the normalization of RI-TIMEXes in the clinical narrative domain: the anchor point hypothesis and the anchor relation hypothesis. We annotated the RI-TIMEXes in three corpora to study the characteristics of RI-TMEXes in different domains. This informed the design of our RI-TIMEX normalization system for the clinical domain, which consists of an anchor point classifier, an anchor relation classifier, and a rule-based RI-TIMEX text span parser. We experimented with different feature sets and performed an error analysis for each system component. The annotation confirmed the hypotheses that we can simplify the RI-TIMEXes normalization task using two multi-label classifiers. Our system achieves anchor point classification, anchor relation classification, and rule-based parsing accuracy of 74.68%, 87.71%, and 57.2% (82.09% under relaxed matching criteria), respectively, on the held-out test set of the 2012 i2b2 temporal relation challenge. Experiments with feature sets reveal some interesting findings, such as: the verbal tense feature does not inform the anchor relation classification in clinical narratives as much as the tokens near the RI-TIMEX. Error analysis showed that underrepresented anchor point and anchor relation classes are difficult to detect. We formulate the RI-TIMEX normalization problem as a pair of multi-label classification problems. Considering only RI-TIMEX extraction and normalization, the system achieves statistically significant improvement over the RI-TIMEX results of the best systems in the 2012 i2b2 challenge. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Patient-reported outcome assessment and objective evaluation of chemotherapy-induced alopecia

NARCIS (Netherlands)

Komen, M.M.; Hurk, C.J. van den; Nortier, J.W.; Ploeg, T. van der; Smorenburg, C.H.; Hoeven, J.J.M. van der

2018-01-01

PURPOSE: Alopecia is one of the most distressing side effects of chemotherapy. Evaluating and comparing the efficacy of potential therapies to prevent chemotherapy-induced alopecia (CIA) has been complicated by the lack of a standardized measurement for hair loss. In this study we investigated the

Linear non scarring alopecia of the scalp: A rare manifestation of lupus panniculitis

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Sandhyarani Kshetrimayum

2016-01-01

Full Text Available Alopecia in a linear pattern is very rare with only a few cases reported in the medical literature. We report a case of linear non scarring alopecia involving the scalp in a 17-year-old boy with a histological diagnosis of lupus panniculitis. We report this case because of its rarity and also the inclusion of this entity as one of the rare differential of non scarring alopecia.

Clinical empathy and narrative competence: the relevance of reading talmudic legends as literary fiction.

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Davidson, John H

2015-04-01

The "curative potential" in almost any clinical setting depends on a caregiver establishing and maintaining an empathic connection with patients so as to achieve "narrative competence" in discerning and acting in accord with their preferences and best interests. The "narrative medicine" model of shared "close reading of literature and reflective writing" among clinicians as a means of fostering a capacity for clinical empathy has gained validation with recent empirical studies demonstrating the enhancement of theory of mind (ToM), broadly conceived as empathy, in readers of literary fiction. Talmudic legends, like that of Rabbi Judah's death, are under-appreciated, relevant sources of literary fiction for these efforts. The limitations of narrative medicine are readily counterbalanced by simultaneously practiced attention to traditional bioethical principles, including-especially-beneficence, non-maleficence, and autonomy.

A mixed methods survey of social anxiety, anxiety, depression and wig use in alopecia.

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Montgomery, Kerry; White, Caroline; Thompson, Andrew

2017-05-04

This study aimed to examine levels of social anxiety, anxiety and depression reported by people with alopecia as a result of a dermatological condition and associations with wig use. The study also sought to report on experiences of wearing wigs in social situations and the relationship with social confidence. A cross-sectional survey was sent by email to the Alopecia UK charity mailing list and advertised on social media. Inclusion criteria were a diagnosis of alopecia, aged 13 or above and sufficient English to complete the survey. Exclusion criteria included experiencing hair loss as a result of chemotherapy treatment or psychological disorder. Participants (n=338) were predominantly female (97.3%), Caucasian (93.5%) and aged between 35 and 54 years (49.4%) with a diagnosis of alopecia areata (82.6%). The Social Phobia Inventory measured symptoms of social anxiety, and the Hospital Anxiety and Depression Scale was used to measure symptoms of anxiety and depression. Survey questions were designed to measure the use of wigs. Open-ended questions enabled participants to comment on their experiences of wearing wigs. Clinically significant levels of social anxiety (47.5%), anxiety (35.5%) and depression (29%) were reported. Participants who reported worries about not wearing a wig reported significantly higher levels of depression: t(103)=3.40, p≤0.001; anxiety: t(109)=4.80, p≤0.001; and social anxiety: t(294)=3.89, p≤0.001. Wearing wigs was reported as increasing social confidence; however, the concealment it afforded was also reported as both reducing fear of negative evaluation and maintaining anxiety. Overall, 46% of participants reported that wearing a wig had a positive impact on their everyday life with negative experiences related to fears of the wig being noticed. Psychological interventions alongside wig provision would be beneficial for people living with alopecia. © Article author(s) (or their employer(s) unless otherwise stated in the text of the

Doing It Collaboratively! Addressing the Dilemmas of Designing Quantitative Effect Studies on Narrative Family Therapy in a Local Clinical Context

DEFF Research Database (Denmark)

Ejbye-Ernst, Ditte; Jørring, Nina Tejs

2017-01-01

suggest that involving narrative clinicians and clients in the development of a research design in the local clinical context might be helpful in overcoming narrative skepticism and criticism towards quantitative effect research. It is our hope that this article will inspire more narrative therapists...... in a local clinical context. The article offers a detailed case description of implementing psychometric effect measurements on narrative family therapy and of creating a shared collaborative stance for researchers using quantitative effect measurements and clinicians using narrative therapy. Our findings......This article suggests an approach for addressing the dilemmas narrative therapists face, wanting to make narrative therapy accessible to people seeking help in contexts favoring evidence-based therapy. The approach is inspired by participatory action research and involves clinicians and clients...

Comparison of the Therapeutic Effect of 2% Topical Minoxidil with Rosemary Solution in the Treatment of Alopecia Areata on the Scalp

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R Yaghmaei

2014-12-01

Full Text Available Background & aim: Alopecia Areata is a chronic inflammatory disease which affects the hair roots. Different drugs and methods are used to treat this disease, nevertheless there is still no cure. The aim of this study was to compare the therapeutic effect of topical Minoxidil 2% solution in the treatment of alopecia areata on the scalp with rosemary solution. Methods: The present clinical-trial study was conducted on 78 patients with Alopecia Areata. Block randomization was designed in two groups of four Minoxidil 2% (n=39 and Rosemary (n=39. During the initial evaluation, patients were assessed in terms of location, number and extent of lesions by a dermatologist, and then the data were recorded. Patients in the intervention group were administered rosemary, as well as those in the control group were given Minoxidil 2%. The patients were instructed to apply the medication to the lesion twice a day. The lesion was re-evaluated two months later. Data were analyzed using SPSS version 18 as well as T-test and Chi-square test and descriptive statistics. Results: There were no significant differences in terms of mean age, mean duration of disease, and alopecia conflict in the patients of two groups (p>0.05. There was no significant difference in cure rates between the two groups (05/0 p>0.05. Conclusions: The findings of this study revealed that both Rosemary and Minoxidil had the same effects on alopecia areata. Due to the fact that the treatment of alopecia areata by rosemary plant is effective and affordable, it can be recommended.

Comparison of the Therapeutic Effect of 2% Topical Minoxidil with Rosemary Solution in the Treatment of Alopecia Areata on the Scalp

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R Yaghmaei

2014-09-01

Full Text Available Background & aim: Alopecia Areata is a chronic inflammatory disease which affects the hair roots. Different drugs and methods are used to treat this disease, nevertheless there is still no cure. The aim of this study was to compare the therapeutic effect of topical Minoxidil 2% solution in the treatment of alopecia areata on the scalp with rosemary solution. Methods: The present clinical-trial study was conducted on 78 patients with Alopecia Areata. Block randomization was designed in two groups of four Minoxidil 2% (n=39 and Rosemary (n=39. During the initial evaluation, patients were assessed in terms of location, number and extent of lesions by a dermatologist, and then the data were recorded. Patients in the intervention group were administered rosemary, as well as those in the control group were given Minoxidil 2%. The patients were instructed to apply the medication to the lesion twice a day. The lesion was re-evaluated two months later. Data were analyzed using SPSS version 18 as well as T-test and Chi-square test and descriptive statistics. Results: There were no significant differences in terms of mean age, mean duration of disease, and alopecia conflict in the patients of two groups (p>0.05. There was no significant difference in cure rates between the two groups (05/0 p>0.05. Conclusions: The findings of this study revealed that both Rosemary and Minoxidil had the same effects on alopecia areata. Due to the fact that the treatment of alopecia areata by rosemary plant is effective and affordable, it can be recommended.

Clinical Empathy and Narrative Competence: The Relevance of Reading Talmudic Legends as Literary Fiction

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John H. Davidson

2015-04-01

Full Text Available The “curative potential” in almost any clinical setting depends on a caregiver establishing and maintaining an empathic connection with patients so as to achieve “narrative competence” in discerning and acting in accord with their preferences and best interests. The “narrative medicine” model of shared “close reading of literature and reflective writing” among clinicians as a means of fostering a capacity for clinical empathy has gained validation with recent empirical studies demonstrating the enhancement of theory of mind (ToM, broadly conceived as empathy, in readers of literary fiction. Talmudic legends, like that of Rabbi Judah’s death, are under-appreciated, relevant sources of literary fiction for these efforts. The limitations of narrative medicine are readily counterbalanced by simultaneously practiced attention to traditional bioethical principles, including—especially—beneficence, non-maleficence, and autonomy.

Systematic review of low-level laser therapy for adult androgenic alopecia.

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Delaney, Sean W; Zhang, Paul

2017-12-29

Alopecia is a common disorder affecting over half of the world's population. Within this condition, androgenic alopecia (AA) is the most common type, affecting 50% of males over 40 and 75% of females over 65. Anecdotal paradoxical hypertrichosis noted during laser epilation has generated interest in the possibility of using laser to stimulate hair growth. In this study, we aimed to critically appraise the application of low-level laser therapy for the treatment of AA in adults. A systematic review was performed on studies identified on Medline, EMBASE, Cochrane database, and clinicaltrials.org. Double-blinded randomized controlled trials were selected and analyzed quantitatively (meta-analysis) and qualitatively (quality of evidence, risk of bias). Low-level laser therapy appears to be a promising noninvasive treatment for AA in adults that is safe for self-administration in the home setting. Although shown to effectively stimulate hair growth when compared to sham devices, these results must be interpreted with caution. Further studies with larger samples, longer follow-up, and independent funding sources are necessary to determine the clinical effectiveness of this novel therapy.

Guidelines on the use of finasteride in androgenetic alopecia

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Venkataram Mysore

2016-01-01

Full Text Available Background: Finasteride is a widely used drug in dermatology for the treatment of androgenetic alopecia. There are many reports of associated sexual side effects. This article reviews the use of once-daily 1 mg finasteride in androgenetic alopecia and its associated sexual adverse effects. Methods: A literature search was performed to collect data on the use of finasteride in male pattern baldness. Relevant literature published till March 2014 was obtained from MEDLINE, EMBASE, CINAHL, Cochrane registers and LILACS. The keywords "finasteride", "male pattern baldness" and "androgenetic alopecia" were used for literature search. Similarly, a search was done for finasteride in female pattern hair loss with keywords "female pattern baldness", "finasteride" and "female pattern alopecia". All systematic reviews, meta-analyses, national guidelines, randomized controlled trials, prospective open label studies and retrospective case series in the English literature were reviewed. Results: Two hundred sixty two studies were evaluated, twelve of which fulfilled the inclusion criteria. Conclusions and Recommendations: Current evidence on the safety of finasteride indicates that it is safe but there is growing concern about its sexual side effects. In view of this, proper information should be provided to patients prior to starting treatment (Level of recommendation 1+, Grade of recommendation B. The reported sexual side effects are few and reverse with stoppage of the drug (Grade of recommendation B but further studies are required.

Guidelines on the use of finasteride in androgenetic alopecia.

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Mysore, Venkataram; Shashikumar, B M

2016-01-01

Finasteride is a widely used drug in dermatology for the treatment of androgenetic alopecia. There are many reports of associated sexual side effects. This article reviews the use of once-daily 1 mg finasteride in androgenetic alopecia and its associated sexual adverse effects. A literature search was performed to collect data on the use of finasteride in male pattern baldness. Relevant literature published till March 2014 was obtained from MEDLINE, EMBASE, CINAHL, Cochrane registers and LILACS. The keywords "finasteride", "male pattern baldness" and "androgenetic alopecia" were used for literature search. Similarly, a search was done for finasteride in female pattern hair loss with keywords "female pattern baldness", "finasteride" and "female pattern alopecia". All systematic reviews, meta-analyses, national guidelines, randomized controlled trials, prospective open label studies and retrospective case series in the English literature were reviewed. Two hundred sixty two studies were evaluated, twelve of which fulfilled the inclusion criteria. Current evidence on the safety of finasteride indicates that it is safe but there is growing concern about its sexual side effects. In view of this, proper information should be provided to patients prior to starting treatment (Level of recommendation 1+, Grade of recommendation B). The reported sexual side effects are few and reverse with stoppage of the drug (Grade of recommendation B) but further studies are required.

Retrospective evaluation of childhood alopecia areata cases

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Munise Daye

2013-09-01

Full Text Available Background and design: Approximately 20% of alopecia areata (AA cases are children. There is limited information about childhood AA.We aimed to examine demographic features,treatments and diseases prognosis of child cases of AA that were followed in our clinic. Material and methods: Datas of 110 AA patients who are 16 and under 16 years old were examined retrospectively.The age,gender,disease onset age,duration of disease,types of AA and onset area,nail involvement, accompanying systemic and dermatological diseases,laboratory tests,treatments and the prognosis were evaluated in their follow-up time.Results: Female cases were 46,4%, male cases were 53,6%.The mean age was 10,35 years.The age of disease onset was 8,65 years.Primary onset areas of AA cases were scalp in 83,6%, eyebrows in 5,4%, body hair in 5,4%, eyelashes in 2,7%, eyebrows and eyelashes in 2,7%.Types of disease were AA in 73,4% cases,alopecia totalis in 19% cases, alopecia universalis in 5,4% cases,ophiaisis in 1,8% cases.Nail involvement was established in 36,3% cases. Nevus flammeus was established in 2,7% cases.Mean disease duration was 17,02 months.Accompaying dermatosis were vitiligo in 2,7% cases,atopic dermatitis in 6,3% cases. The accompaying systemic diseases were autoimmune thyroiditis in 1,8% cases and Down's Syndrome in 2,7% cases.Thyroid autoantibodies were high in 0,9% cases.We have treated 24,5% of cases with topical corticosteroid lotion, 30,9% of cases with anthralin, 0,9%of cases with 2% minoxidil lotion, 0,9% of cases with calcipotriol lotion, 1,8% of cases with topical calcineurin inhibitors, 10% of cases with intralesional corticosteroids.We have treated 15,4% of cases with systemic corticosteroids and PUVA therapy who were resistant to topical treatment.We have treated 14,5% of cases with different combinations of topical treatments.Remission was observed in 34,5% of cases.The mean remission duration was 12.2 months.Relapse was observed at a average of two

Diagnosis of Hair Loss: Clinical features of common causes of hair loss

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Coupe, Robert L.M.

1992-01-01

Common causes of hair loss include androgenic hair loss, alopecia areata, trichotillomania, tinea capitis, telogen effluvium, and traction alopecia. The author discusses their distinguishing clinical features and those of less common alopecias.

Alopecia and its association with coronary heart disease and cardiovascular risk factors: a meta-analysis.

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Trieu, Nelson; Eslick, Guy D

2014-10-20

Alopecia has been associated with an increased risk of coronary heart disease as well as the following risk factors for cardiovascular disease: hyperinsulinaemia, insulin resistance, metabolic syndrome, dyslipidaemia, and hypertension. We performed a meta-analysis to quantitatively determine the level of risk of coronary heart disease and risk factors in individuals with alopecia. A systematic literature search was conducted using several databases. We calculated pooled odds ratios and 95% confidence intervals using a random effects model. In total, 31 studies comprising 29,254 participants with alopecia were eligible for the meta-analysis and showed that alopecia is associated with an increased risk of coronary heart disease (OR 1.22, 95% CI: 1.07-1.39), hyperinsulinaemia (OR 1.97, 95% CI: 1.20-3.21), insulin resistance (OR 4.88, 95% CI: 2.05-11.64), and metabolic syndrome (OR 4.49, 95% CI: 2.36-8.53). Individuals with alopecia were also shown to be more likely compared to those without alopecia to have higher serum cholesterol levels (OR 1.60, 95% CI: 1.17-2.21), higher serum triglyceride levels (OR 2.07, 95% CI: 1.32-3.25), higher systolic blood pressures (OR 1.73, 95% CI: 1.29-2.33), and higher diastolic blood pressures (OR 1.59, 95% CI: 1.16-2.18). Alopecia is associated with an increased risk of coronary heart disease, and there appears to be a dose-response relationship with degree of baldness whereby the greater the severity of alopecia, the greater the risk of coronary heart disease. Alopecia is also associated with an increased risk of hypertension, hyperinsulinaemia, insulin resistance, metabolic syndrome, and having elevated serum total cholesterol and triglyceride levels. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.

Identification of SNP c.-22G>A in the melanophilin gene from a dog with color dilution alopecia: case report

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L.M. Santos

Full Text Available ABSTRACT Mutant color alopecia is an ectodermical defection of color dilution, characterized by partial alopecia, dry, shine-less hair, and peeling and papule. Melanization damages also occur on the cortical structure of the affected hair. The animals affected have big melanin grains with irregular shape on the basal keratinocytes, also on the hair matrix cells and rod. Therefore, there is not a specific treatment that makes any difference on the syndrome evolution. Although in some animals, it is possible to use weekly showers with benzyl peroxide to reduce seborrhea formation and secondary infections. There is evidence that the condition in dogs is caused by a single nucleotide polymorphism in the gene encoding the melanophilin protein. In the present study the identification of the SNP c.-22G>A in the melanophilin gene of a Dachshund breed dog with clinical and histopathologic evidence of color dilution alopecia is reported.

Microneedling as a successful treatment for alopecia X in two Pomeranian siblings.

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Stoll, Steve; Dietlin, Christian; Nett-Mettler, Claudia S

2015-10-01

Alopecia X (hair cycle arrest) is a relatively frequent hair growth disorder in Pomeranians and several other breeds, characterized by symmetrical, noninflammatory alopecia without systemic signs. The cause and pathogenesis remain unknown. Previously reported treatments with various topical and systemic drugs have been variably successful. We hypothesized that superficial mechanical skin trauma applied with a microneedling device would induce long-term hair regrowth at treated sites. Two neutered female Pomeranian siblings with histologically confirmed alopecia X. Previous treatments with deslorelin, melatonin and topical minoxidil had failed to produce significant hair regrowth. The dogs were anaesthetized and the skin was punctured with a microneedling device. Dogs were followed over a period of 12 months. Five weeks after microneedling hair regrowth started, followed by a reduction in hyperpigmentation of affected skin. After 12 weeks there was a 90% improvement in coat coverage at previously alopecic areas. Twelve months after the procedure, coat conditions remained stable. No adverse effects were noted. This is the first report of microneedling to induce hair regrowth in dogs affected by alopecia X. Long-term studies with microneedling in a larger number of dogs with alopecia X will need to be performed to confirm these preliminary results and to further evaluate if hair-regrowth is permanent. © 2015 ESVD and ACVD.

[Localized inflammatory alopecia of the scalp: an unusual presentation of tularemia].

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Berton, M; Nojavan, H; Bens, G; Estève, E

2012-04-01

Tularaemia is a rare arthropod-borne zoonotic infection with 20 to 70 new cases being seen each year in France. Cutaneous ulceration and regional lymphadenopathy are the classical dermatological signs. Diagnosis of atypical forms is more complex. A 48-year-old woman was admitted for an erythematous papular alopecic lesion of the scalp accompanied by fever, chills and cervical lymphadenopathy. Initial antibiotic therapy for 20 days with amoxicillin clavulanate was ineffective. The patient's history included an episode of hunting in the forest three days before the onset of signs. Finally, serology led to the diagnosis of tularaemia. Combined levofloxacin and doxycycline resulted in regression of the scalp lesion and lymph node disorder. The existence of alopecia and location on the scalp did not initially suggest a diagnosis of tularaemia to us. The clinical presentation was highly suggestive of impetigo with satellite lymphadenopathies. However, resistance to antibiotics and the absence of inflammation militated against this diagnosis, and other possible diagnoses such as a tick-borne lymphadenopathy (TIBOLA), borreliosis and tularaemia were discussed. The most common clinical presentation of tularaemia is ulceroglandular tularaemia, which predominates in 80% of cases. The inoculation chancre at the point of initial infection is most often located in the upper limbs. An inflammatory plaque on the scalp with alopecia may reveal tularaemia, a potentially fatal disease resulting from inoculation. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

[Efficacy and tolerability of 5% minoxidil solution (Carexidil®) in male and female androgenetic alopecia: a 6-month open multicentric study].

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Piraccini, B; Starace, M; Alessandrini, A; Guarrera, M; Fiorucci, M C; Lorenzi, S

2011-12-01

The aim of the study was to evaluate efficacy and safety of 5% Carexidil solution®, applied twice a day on the scalp, on male and female androgenetic alopecia. The 6 month-study was performed in three Italian dermatological centers. Evaluation of efficacy was performed with subjective and objective methods, including operator and patient assessments, global photography and videodermoscopy. Global photography revealed that after 6 months of treatment with 5% Carexidil solution®, androgenetic alopecia was improved in all 32 females and 16 males. Alopecia stopped to progress in 6 males. Scalp videodermoscopy confirmed the results. Some patients complained of increased hair greasiness, others complained of mild scalp itching. Two female patients developed contact sensitization to minoxidil, confirmed by patch test, 2 a mild malar-temporal hypertrichosis. All patients were satisfied by treatment and continued it after the end of the study. Our study confirms the data of the literature and the evidence coming from years of clinical experience, that twice a day topical application of 5% minoxidil solution, Carexidil ®, is effective in the treatment of male and female androgenetic alopecia, with evident efficacy already after 6 months.

The use of systematic reviews in clinical trials and narrative reviews in dermatology: is the best evidence being used?

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Conde-Taboada, A; Aranegui, B; García-Doval, I; Dávila-Seijo, P; González-Castro, U

2014-04-01

Systematic reviews -the most comprehensive type of literature review-should be taken into account before a clinical trial or a narrative review on a topic is undertaken. The objective of this study was to describe the use of systematic reviews in clinical trials and narrative reviews in dermatology. This was a descriptive cross-sectional study. We selected randomized clinical trials and narrative reviews from the dermatological clinical research journals identified as most important (according to impact factor) and from Actas Dermosifiliográficas, and studied the bibliographies to ascertain whether the authors made reference to existing systematic reviews and Cochrane reviews. Of the 72 clinical trials for which a systematic review was available, 24 (33.3%) cited at least 1 review; reference was made to relevant Cochrane reviews in 15.6% of cases and to non-Cochrane reviews in 32%. In the case of the 24 narrative reviews for which a review was available, 10 (41.7%) cited at least 1 review; Cochrane reviews were cited in 20% and non-Cochrane reviews in 35.3%.In the case of Actas Dermosifiliográficas, very few clinical trials were found and the findings for narrative review articles were similar to those observed for the other journals. Systematic reviews are not often taken into account by the authors of clinical trials and narrative reviews and this may lead to redundant studies and publications. Authors appear to use Cochrane reviews even less than non-Cochrane reviews and are therefore ignoring one of the main sources of available evidence. Copyright © 2013 Elsevier España, S.L. and AEDV. All rights reserved.

Public health nurses perception of clinical leadership in Ireland: narrative descriptions.

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Carney, Marie

2009-05-01

The aim of the study was to identify how clinical leadership skills are perceived by Public Health Nurses in the course of their everyday work and the effectiveness and consequences of such skills in primary care delivery. Public health nurses deliver primary care to children and adults as part of small teams or in individual situations. Leadership skills are needed to fulfil their many roles. Rigorous analysis of narrative interviews with public health nurses working in primary care environments in Ireland was undertaken. Narrative information was obtained by having conversations with 20 public health nurses relating to their perceptions on what clinical leadership meant to them and how their leadership skills influenced effective primary care delivery. Analysis of conversations identified the tensions existing between the various roles and responsibilities of the public health nurse and other primary care workers. This tension was perceived by the nurses as being the main barrier to effective primary care delivery from their perspective. Clinical leadership is viewed narrowly by public health nurses as management skills rather than leadership skills were mainly identified. Education for the role was identified as a critical success factor. RELEVANCE TO NURSE MANAGERS: Public health nurses are well placed to shape and influence health service culture through effective clinical leadership.

Dosimetric analysis of the alopecia preventing effect of hippocampus sparing whole brain radiation therapy

International Nuclear Information System (INIS)

Mahadevan, Anand; Sampson, Carrie; LaRosa, Salvatore; Floyd, Scott R.; Wong, Eric T.; Uhlmann, Erik J.; Sengupta, Soma; Kasper, Ekkehard M.

2015-01-01

Whole brain radiation therapy (WBRT) is widely used for the treatment of brain metastases. Cognitive decline and alopecia are recognized adverse effects of WBRT. Recently hippocampus sparing whole brain radiation therapy (HS-WBRT) has been shown to reduce the incidence of memory loss. In this study, we found that multi-field intensity modulated radiation therapy (IMRT), with strict constraints to the brain parenchyma and to the hippocampus, reduces follicular scalp dose and prevents alopecia. Suitable patients befitting the inclusion criteria of the RTOG 0933 trial received Hippocampus sparing whole brain radiation. On follow up, they were noticed to have full scalp hair preservation. 5 mm thickness of follicle bearing scalp in the radiation field was outlined in the planning CT scans. Conventional opposed lateral WBRT radiation fields were applied to these patient-specific image sets and planned with the same nominal dose of 30 Gy in 10 fractions. The mean and maximum dose to follicle bearing skin and Dose Volume Histogram (DVH) data were analyzed for conventional and HS-WBRT. Paired t-test was used to compare the means. All six patients had fully preserved scalp hair and remained clinically cognitively intact 1–3 months after HS-WBRT. Compared to conventional WBRT, in addition to the intended sparing of the Hippocampus, HS-WBRT delivered significantly lower mean dose (22.42 cGy vs. 16.33 cGy, p < 0.0001), V 24 (9 cc vs. 44 cc, p < 0.0000) and V 30 (9 cc vs. 0.096 cc, p = 0.0106) to follicle hair bearing scalp and prevented alopecia. There were no recurrences in the Hippocampus area. HS-WBRT, with an 11-field set up as described, while attempting to conserve hippocampus radiation and maintain radiation dose to brain inadvertently spares follicle-bearing scalp and prevents alopecia

Dermoscopic clues to distinguish trichotillomania from patchy alopecia areata

OpenAIRE

Abraham, Leonardo Spagnol; Torres, Fernanda Nogueira; Azulay-Abulafia, Luna

2010-01-01

INTRODUÇÃO: Tricotilomania e alopecia areata em placa possuem características clínicas e dermatoscópicas semelhantes. OBSERVAÇÕES: O exame dermatoscópico da tricotilomania revela densidade capilar diminuída, cabelos fraturados em diferentes tamanhos, enovelados e vellus, tricoptilose, pontos amarelos com ou sem pontos pretos e ausência de cabelos em "ponto de exclamação". CONCLUSÃO: No contexto de alopecia em placa e cabelos fraturados, a ausência de "pontos de exclamação" sugere o diagnóstic...

Hair regrowth with topical triiodothyronine ointment in patients with alopecia areata: a double-blind, randomized pilot clinical trial of efficacy.

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Nasiri, S; Haghpanah, V; Taheri, E; Heshmat, R; Larijani, B; Saeedi, M

2012-05-01

Thyroid hormone receptors are expressed in hair follicles and it is known that thyroid hormones can have a positive effect on hair growth, i.e. process which is disrupted in alopecia areata. The aim of this study was to determine the efficacy of topical triiodothyronine in patients with patchy alopecia areata. Ten patients with patchy alopecia areata were treated with triiodothyronine and placebo applied twice daily to either of two bilaterally symmetrical patches for 12 weeks. The two sides were randomly assigned following simple randomization procedure to one of the two treatment groups. The patients and the investigator were blinded to the content of the tubes. Hair regrowth was evaluated every 4 weeks. Blood samples for measurements of complete blood count along with thyroid function (T3, T4 and TSH) and liver function tests were taken at the baseline and at the end of study. After 12 weeks of treatment, there was no statistically significant difference between the outcome in terms of reduction of the patch size and hair regrowth. No adverse effects were noted. Triiodothyronine in the studied dosage and formulation was safe but not more effective than placebo. However, newer thyroid hormone analogues might be more effective and evaluating their effects probably warrants further consideration. © 2011 The Authors. Journal of the European Academy of Dermatology and Venereology © 2011 European Academy of Dermatology and Venereology.

Use of low-level laser therapy in treatment of the androgenic alopecia, the first systematic review.

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Najem, Ibrahim; Chen, Hongxiang

2017-12-11

Alopecia is a common disease affecting more than half of the world total number of people. Alopecia exists in different types, but one of the most common of these types is the Androgenic Alopecia which has affected approximately 51% of the total number of males ranging between the age bracket of 40 years and 75 years. This type of alopecia is more common in females who are above the age of 65 years and above. Despite this widespread effect, much has not been done regarding identifying the possible drugs for treating this disease. At present, there exist only two possible medications that have been scientifically approved to cure this disease, include finasteride and minoxidil. Also, another possible form of treatment has been the case of hair transplantation. Despite the new possible treatment options available for treatment of different types of hair loss, there is a need for the invention for more efficient management and treatment options that are less costly, environmentally friendly, and most importantly human consumption friendly. Due to the recent evaluation that low-level laser therapy stimulated hair growth. This systematic review and meta-analysis was to determine whether the use of low-level laser therapy is an effective therapy for treatment of the Androgenic alopecia and also to some degree we reviewed the level of the patient's satisfaction. Some earlier studies had shown that the use of low-level laser therapy stimulated the hair growth when mice were treated with chemotherapy which was induced by the alopecia and also the other type of alopecia called alopecia areata. The researchers hypothesized that the primary mechanism of treating Androgenic alopecia to be the stimulation of the epidermal stem cells which are in the hair follicle making them bulge and shift the follicles into the anagen phase.

Women entering clinical psychology: Q-sort narratives of career attraction of female clinical psychology trainees in the UK.

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Baker, Martyn; Nash, Jen

2013-01-01

The great majority of the UK clinical psychology workforce are women, and this fact prompted an examination of the various ways clinical psychology might be seen as attractive to women--a neglected research topic. Female clinical psychology trainees from a variety of training programmes Q-sorted statements of potential job attractors. The process of analysis is outlined before most of the article is devoted to explicating the five narratives of attraction generated: making a difference, waiting for what I want, idealising challenge, identifying with distress and acknowledging power and privilege. Two super-ordinate 'stories' spanning the narratives are suggested--an over-riding attraction to the profession and a rebuttal of the suggestion that this attraction may be based on any overtly gendered grounds. In the absence of previous empirical data of women's attraction to clinical psychology, the small but significant contribution to understanding the profession made by the analysis is acknowledged--as is the need for further research to confirm and develop the findings. Copyright © 2011 John Wiley & Sons, Ltd.

Epidemiological survey of dermatophytosis in meat rabbits with alopecia in Portugal

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Fernando Moreira

2012-04-01

Full Text Available An epidemiological dermatophytosis survey was carried out in farmed rabbits with alopecia in Northern and Central Portugal.  Between August and October 2008, samples from suspected clinical cases of alopecia in meat rabbits on industrial farms were collected and cultured by conventional methods.  Effects on the prevalence of several variables, such as breed, age, month of sample collection, configuration of the lesions and presence of concomitant infections in the rabbitries were evaluated using a logistic regression model.  The overall prevalence of dermatophytes species was 82.7% (95% CI: 80.1-85.3%. Two dermatophytes species were isolated: Trichophyton mentagrophytes (91.9% and Microsporum canis (8.1%.  Five variables were associated with dermatophyte isolation in univariate analysis.  The multivariate logistic regression model identified configuration of lesions (OR=3.15; 95% CI: 1.39-7.15% and the presence of concomitant infections on the farms (OR=2.71; 95% CI: 1.03-7.12% as risk factors.  Considering the paucity of epidemiological reports in this country, these results could make a useful contribution towards the diagnosis and prevention of rabbit dermatophytosis.

Theory and practice of clinical ethics support services: narrative and hermeneutical perspectives.

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Porz, Rouven; Landeweer, Elleke; Widdershoven, Guy

2011-09-01

In this paper we introduce narrative and hermeneutical perspectives to clinical ethics support services (CESS). We propose a threefold consideration of 'theory' and show how it is interwoven with 'practice' as we go along. First, we look at theory in its foundational role: in our case 'narrative ethics' and 'philosophical hermeneutics' provide a theoretical base for clinical ethics by focusing on human identities entangled in stories and on moral understanding as a dialogical process. Second, we consider the role of theoretical notions in helping practitioners to understand their situation in clinical ethics practice, by using notions like 'story', 'responsibility', or 'vulnerability' to make explicit and explain their practical experience. Such theoretical notions help us to interpret clinical situations from an ethical perspective and to foster moral awareness of practitioners. And, thirdly, we examine how new theoretical concepts are developed by interpreting practice, using practice to form and improve our ethical theory. In this paper, we discuss this threefold use of theory in clinical ethics support services by reflecting on our own theoretical assumptions, methodological steps and practical experiences as ethicists, and by providing examples from our daily work. In doing so, we illustrate that theory and practice are interwoven, as theoretical understanding is dependent upon practical experience, and vice-versa. © 2011 Blackwell Publishing Ltd.

The emotional impact of loss narratives: event severity and narrative perspectives.

Science.gov (United States)

Habermas, Tilmann; Diel, Verena

2010-06-01

Out of the complex influences of event, narrative and listener characteristics on narrative emotions, this paper focuses on event severity, narrative perspectives, mood, and dispositions for emotion regulation and empathy. Event severity and perspective representation were systematically varied in sad autobiographical narratives to study their influence on quantity and quality of readers' emotional response. Each of three stories were manipulated to contain elaborated perspectives, only the past protagonists' perspective (dramatic narration), and very little perspectives at all (impersonal narration). We predicted that event severity influences the quantity of emotional response, while degree of perspective representation influences plausibility and whether emotional responses are sympathetic or interactional, that is, directed against the narrator. Hypotheses were confirmed except for plausibility, and perspective representation had an effect only on anger against and dislike of the narrator. In a second study, impersonal narration evoked anger at and negative evaluations of the narrator which were related to blaming the narrator for showing too little emotional involvement. The generalizability of findings across emotions and implications for sharing of emotions in everyday and clinical settings are discussed.

Androgenic alopecia in women: an Indian perspective.

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Sehgal, Virendra N; Srivastava, Govind; Aggarwal, Ashok K; Midha, Reshmi

2013-01-01

The authors sought to investigate androgenic alopecia (AA) utilizing clinical and investigative procedures to establish the pattern of AA in the Indian subcontinent. A total of 35 consecutive women presenting with AA were included. After obtaining informed consent, a detailed history/examination, hair pull test, trichogram, and a scalp biopsy were performed in patients. AA classification was attempted across Ludwig and Norwood guidelines. Of 35 women, 16 had grade I, 10 had grade II, and 1 had grade III Ludwig classification. In addition, 6 other women had Christmas tree baldness: 1 each of fronto-parietal and male pattern baldness. Several investigations including hormonal profile were inconclusive; however, hair pull test and trichogram may be helpful in understanding the sequence in AA in women. AA has infrequently been reported, particularly India and in Asia in general.

Pili Annulati Coincident with Alopecia Areata, Autoimmune Thyroid Disease, and Primary IgA Deficiency: Case Report and Considerations on the Literature

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E. Castelli

2012-11-01

Full Text Available Pili annulati is a rare autosomal dominant hair disorder clinically characterized by a pattern of alternating bright and dark bands of the hair, the bright bands appearing dark if observed by transmitted light. This pattern is due to the periodic occurrence of air-filled cavities along the hair cortex which scatter and reflect the light while precluding its transmission. A susceptibility region, including a possibly responsible Frizzled gene, has been mapped to the telomeric region of chromosome 12q, although a specific mutation has not been identified. The condition has sometimes been observed in concurrence with alopecia areata, and in this paper we report a case in whom the concomitant severe alopecia areata was associated with autoimmune thyroid disease and primary IgA deficiency – a quadruple complex which, to our knowledge, has never been previously described. The occurrence of multiple immune disorders in the same patient affected by pili annulati could represent a key to understanding the high prevalence of alopecia areata in this condition. Specifically, in individuals predisposed to autoimmune disease, the molecular alterations that cause the anatomical changes of pili annulati could prompt the immune response against the hair root that underlies alopecia areata.

Narratives of social justice: learning in innovative clinical settings.

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Reimer Kirkham, Sheryl; Van Hofwegen, Lynn; Hoe Harwood, Catherine

2005-01-01

The nursing profession has renewed its commitment to social and political mandates, resulting in increasing attention to issues pertaining to diversity, vulnerable populations, social determinants of health, advocacy and activism, and social justice in nursing curricula. Narratives from a qualitative study examining undergraduate nursing student learning in five innovative clinical settings (corrections, international, parish, rural, and aboriginal) resonate with these curricular emphases. Data were derived from focus groups and interviews with 65 undergraduate nursing students, clinical instructors, and RN mentors. Findings of this study reveal how students in innovative clinical placements bear witness to poverty, inequities, and marginalization (critical awareness), often resulting in dissonance and soul-searching (critical engagement), and a renewed commitment to social transformation (social change). These findings suggest the potential for transformative learning in these settings.

DEVELOPMENT OF ALOPECIA DURING TREATMENT WITH A TUMOR NECROSIS FACTOR-ALPHA INHIBITOR IN A FEMALE PATIENT WITH PSORIATIC ARTHRITS: A CLINICAL CASE

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R. G. Mukhina

2016-01-01

Full Text Available Objective: to describe a case of the total development of alopecia in a female patient with psoriatic arthritis during treatment with a tumor necrosis factor-αlpha (TNF-α inhibitor. Materials and methods. Patient I., aged 36 years has been followed up at the Kazan’ Center of Rheumatic Diseases and Osteoporosis since 1998. At approximately the same time, the patient noted the appearance of skin eruptions behind the ears, on the skin of the scalp. She was examined by a dermatologist who diagnosed psoriasis. In 2005, she was admitted to Kazan’ Rheumatology Center, City Clinical Hospital Seven, for the development of obvious synovitis of the knee joint and for the inefficiency of therapy with nonsteroidal anti-inflammatory drugs and diagnosed with psoriatic arthritis. During the prescribed therapy with methotrexate 10 mg/week, evident menstrual irregularities were observed in the patient who stopped using the drug herself. The second pregnancy occurred in 2008. Articular syndrome progression and eruptive psoriasis were recorded in the lactation period. After lactation cessation in 2009, she was hospitalized again. Her examination revealed high laboratory activity (erythrocyte sedimentation rate, as high as 40 mm/hr; magnetic resonance imaging of the knee joints showed the signs of bilateral synovitis; lumbar spine radiography exhibited grade II sacroiliitis. Leflunomide 20 mg/day was recommended as a basic drug. In 2012, the patient used leflunomide, her condition worsened; joint pain progressed; new joints were involved into the process, and cutaneous manifestations were aggravated. To verify a diagnosis and to choose therapy, the patient was referred to a consultation at the Moscow Research Institute of Rheumatology. Results. In connection with the high activity of the disease and with no response to the performed therapy, it was recommended to initiate therapy with biologics, such as infliximab, the drug of choice. Seven infliximab

Narrative meaning making is associated with sudden gains in psychotherapy clients' mental health under routine clinical conditions.

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Adler, Jonathan M; Harmeling, Luke H; Walder-Biesanz, Ilana

2013-10-01

The present study had two aims: (a) to replicate previous findings regarding the characteristics of sudden gains (SGs) in psychotherapy under routine clinical conditions and (b) to examine whether clients' narrative meaning-making processes were associated with SGs in mental health. 54 psychotherapy clients completed the Systemic Therapy Inventory of Change (Pinsof et al., 2009) and wrote private narratives prior to beginning treatment and between every session for 12 assessment points over the course of psychotherapy for a variety of presenting problems. Clients' narratives were coded using existing systems (Adler, 2012; A. M. Hayes, Feldman, & Goldfried, 2006) to assess their content in eight themes: processing, avoidance, coherence, positive self, negative self, agency, hope, and hopelessness. The prevalence, magnitude, and timing of SGs in mental health observed in the present study were similar to those observed in prior research. Two narrative meaning-making processes-processing and coherence-were significantly associated with SGs in mental health. The present study significantly extends prior research on SGs, replicating the characteristics of these gains in routine clinical conditions with a measure of general functioning and identifying two narrative meaning-making processes that are associated with SGs in mental health.

Cold thermal injury from cold caps used for the prevention of chemotherapy-induced alopecia.

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Belum, Viswanath Reddy; de Barros Silva, Giselle; Laloni, Mariana Tosello; Ciccolini, Kathryn; Goldfarb, Shari B; Norton, Larry; Sklarin, Nancy T; Lacouture, Mario E

2016-06-01

The use of scalp cooling for the prevention of chemotherapy-induced alopecia (CIA) is increasing. Cold caps are placed onto the hair-bearing areas of the scalp for varying time periods before, during, and after cytotoxic chemotherapy. Although not yet reported, improper application procedures could result in adverse events (AEs). At present, there are no evidence-based scalp cooling protocols, and there is no regulatory oversight of their use. To report the occurrence of cold thermal injury (frostbite) on the scalp, following the use of cold caps for the prevention of CIA. We identified four patients who developed cold thermal injuries on the scalp following the application of cold caps. Medical records were analyzed to retrieve the demographic and clinical characteristics. The cold thermal injuries in our patients were grade 1/2 in severity and improved with topical interventions and interruption of cold cap use, although grade 1 persistent alopecia ensued in 3 patients. The true incidence of such injuries in this setting, however, remains unknown. Cold thermal injuries are likely infrequent and preventable AEs that may result from improper device application procedures during cold cap use. Although these untoward events are usually mild to moderate in severity, the potential occurrence of long-term sequelae (e.g., permanent alopecia and scarring) or the need to discontinue cold cap use, are not known. Prospective studies are needed to further elucidate the risk and standardize healthcare delivery methods, and to improve patient/supportive/healthcare provider education.

Ichthyosiform mycosis fungoides with alopecia and atypical membranous nephropathy

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Qiang Zhou

2011-01-01

Full Text Available We describe here a rare case of variant of mycosis fungoides (MF: ichthyosiform MF with alopecia and atypical membranous nephropathy. The diagnosis was made based on the following findings: generalized ichthyosis-like eruption, alopecia, enlarged superficial lymph nodes, proteinuria, and hematuria, the histological features of the skin biopsy from both ichthyotic and alopecic lesions with immunohistochemical staining, and the renal biopsy examination with immunofluorescence. The histological examination of ichthyotic and alopecic lesions displayed a predominant infiltration of atypical lymphocytes in the upper dermis with the characteristics of epidermotropism and folliculotropism. Immunohistochemical studies demonstrated that most infiltrated atypical lymphocytes were CD3, CD4, and CD45RO positive, whereas negative for CD5, CD7, CD20, CD30, and CD56. A renal biopsy examination revealed atypical membranous nephropathy with deposition of immunoglobulin G (IgG, IgM, IgA, C1q, and C3. In this case atypical membranous nephropathy was involved, which is very uncommon and has never been presented in the literature to date. Although ichthyosiform MF usually features a relatively favorable course, diffuse alopecia and the renal involvement in this case might indicate aggressive disease and poor prognosis.

Improving performance of natural language processing part-of-speech tagging on clinical narratives through domain adaptation.

Science.gov (United States)

Ferraro, Jeffrey P; Daumé, Hal; Duvall, Scott L; Chapman, Wendy W; Harkema, Henk; Haug, Peter J

2013-01-01

Natural language processing (NLP) tasks are commonly decomposed into subtasks, chained together to form processing pipelines. The residual error produced in these subtasks propagates, adversely affecting the end objectives. Limited availability of annotated clinical data remains a barrier to reaching state-of-the-art operating characteristics using statistically based NLP tools in the clinical domain. Here we explore the unique linguistic constructions of clinical texts and demonstrate the loss in operating characteristics when out-of-the-box part-of-speech (POS) tagging tools are applied to the clinical domain. We test a domain adaptation approach integrating a novel lexical-generation probability rule used in a transformation-based learner to boost POS performance on clinical narratives. Two target corpora from independent healthcare institutions were constructed from high frequency clinical narratives. Four leading POS taggers with their out-of-the-box models trained from general English and biomedical abstracts were evaluated against these clinical corpora. A high performing domain adaptation method, Easy Adapt, was compared to our newly proposed method ClinAdapt. The evaluated POS taggers drop in accuracy by 8.5-15% when tested on clinical narratives. The highest performing tagger reports an accuracy of 88.6%. Domain adaptation with Easy Adapt reports accuracies of 88.3-91.0% on clinical texts. ClinAdapt reports 93.2-93.9%. ClinAdapt successfully boosts POS tagging performance through domain adaptation requiring a modest amount of annotated clinical data. Improving the performance of critical NLP subtasks is expected to reduce pipeline error propagation leading to better overall results on complex processing tasks.

Women entering clinical psychology: Q-sort narratives of career attraction of female clinical psychology trainees in the UK

OpenAIRE

Baker, Martyn; Nash, Jen

2011-01-01

The great majority of the UK clinical psychology workforce is female, and this fact prompted an examination of the various ways clinical psychology might be seen as attractive to women – a neglected research topic. Female clinical psychology trainees from a variety of training programmes Q-sorted statements of potential job attractors. The process of analysis is outlined, before most of the article is devoted to explicating the five narratives of attraction generated: making a difference, wai...

A pilot study to evaluate effectiveness of botulinum toxin in treatment of androgenetic alopecia in males

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Sehdev Singh

2017-01-01

Full Text Available Introduction: Androgenetic alopecia is a common form of alopecia with multifactorial etiology. Finasteride and minoxidil are approved by the FDA for the treatment of androgenetic alopecia. Balding scalp is believed to have relative microvascular insufficiency. Blood vessels in the scalp travel through the intramuscular plane. Intramuscular injection of botulinum toxin relaxes muscles and thereby increases blood flow in balding scalp. We conducted a pilot study to evaluate the efficacy of botulinum toxin in androgenetic alopecia management. Material and Methods: The study was conducted in a tertiary care center. A total of 10 male patients with androgenetic alopecia meeting inclusion criteria of the study were included. In the scalp, 30 sites were injected with 5 U of botulinum toxin in each site. Preprocedure photograph taken and evaluation was done, which was repeated after 24 weeks. Efficacy was assessed by photography and self-assessment scoring was done by patients. Results: Of 10 patients, 8 had good to excellent response on photographic assessment. At the end of 24 weeks, 1 patient showed poor and 1 showed fair response to treatment. As per self-assessment, 7of 10 patients showed good to excellent response. Two patients had fair response and 1 patient showed poor response to treatment. Conclusion: Botulinum toxin was found to be safe and effective therapy for the management of androgenetic alopecia in this pilot study. Studies with larger sample size and randomized controlled trials are required to establish the role of botulinum toxin in the management of androgenetic alopecia.

Effects of heavy ions on rabbit tissues: alopecia

International Nuclear Information System (INIS)

Cox, A.B.; Keng, P.C.; Glass, N.L.; Lett, J.T.

1981-01-01

The skin surrounding the eyes of New Zealand white rabbits was exposed to Bragg plateau regions of 530 MeV/amu Ar ions and 365 MeV/amu Ne ions, and to 60 Co γ rays. Linear energy transfers (LETsub(infinity)s) for the radiations were 90 +- 5, 35 +- 3, and 0.3 keV/μm, respectively. Post-irradiation alopecia was measured with subjective indices of baldness (0-5) calibrated against hair loss in rabbits irradiated with Ne and Ar ions at the central region of the ear. Patterns of post-irradiation alopecia, conforming to the model proposed by Casarett (1963) for the long-term expression of radiation damage in proliferating animal tissues, were modified by radiation quality as follows: (1) For early losses, the magnitude of the recovery phase decreased as the LETsub(infinity) of the incident radiation increased; (2) In the plateau phase of radiation response r.b.e. values approached those reported for proliferating cells in culture, but differences were found that may be related to changes in the magnitude of the recovery phase; (3) For a given level of intermediate damage, onset of the late degenerative phase of radiation response, which was expressed years after irradiation, occurred earlier the higher the LETsub(infinity) of the incident radiation. The most important finding was that r.b.e.s for alopecia varied with post-irradiation time. (author)

Drug discovery for alopecia: gone today, hair tomorrow.

Science.gov (United States)

Santos, Zenildo; Avci, Pinar; Hamblin, Michael R

2015-03-01

Hair loss or alopecia affects the majority of the population at some time in their life, and increasingly, sufferers are demanding treatment. Three main types of alopecia (androgenic [AGA], areata [AA] and chemotherapy-induced [CIA]) are very different, and have their own laboratory models and separate drug-discovery efforts. In this article, the authors review the biology of hair, hair follicle (HF) cycling, stem cells and signaling pathways. AGA, due to dihydrotesterone, is treated by 5-α reductase inhibitors, androgen receptor blockers and ATP-sensitive potassium channel-openers. AA, which involves attack by CD8(+)NK group 2D-positive (NKG2D(+)) T cells, is treated with immunosuppressives, biologics and JAK inhibitors. Meanwhile, CIA is treated by apoptosis inhibitors, cytokines and topical immunotherapy. The desire to treat alopecia with an easy topical preparation is expected to grow with time, particularly with an increasing aging population. The discovery of epidermal stem cells in the HF has given new life to the search for a cure for baldness. Drug discovery efforts are being increasingly centered on these stem cells, boosting the hair cycle and reversing miniaturization of HF. Better understanding of the molecular mechanisms underlying the immune attack in AA will yield new drugs. New discoveries in HF neogenesis and low-level light therapy will undoubtedly have a role to play.

Utility of dermoscopy in alopecia areata

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Mandar Mane

2011-01-01

Full Text Available Background: Alopecia areata (AA shows several well-defined dermoscopic features which may help in confirming diagnosis in AA. Aims: We carried out a study to examine the dermoscopic features of AA and develop a protocol for diagnosis of AA by dermoscopy. Materials and Methods: Dermoscopy was performed in 66 patients with AA. Hanse HVS-500NP dermoscope (magnification of ×32 and ×140 was used. Results: The mean age of the patients (46 males and 20 females was 26.85 years. The mean age of onset was 25.15 years. The mean duration of alopecia was 10.3 months. Most common AA in our study was patchy type (57/66, 87.7%. Single patch was seen in 24 patients and multiple patches in 33 patients. Diffuse AA was seen in five patients. Ophiasis and alopecia universalis were seen in two patients each. Nail changes were fine pitting (4, ridging (2, thinning of nail plate (2. Twenty nail dystrophy, distal onycholysis, striate leukonychia and coarse pitting were seen in one patient each. Intralesional triamcinolone acetonide was the most common therapy offered. Others were oral betamethasone minipulse therapy, dexamethasone pulse, minoxidil, anthralin and corticosteroids. The most common dermoscopic finding was yellow dots seen in 54 patients (81.8%, followed by black dots (44 patients, 66.6%, broken hairs (36 patients, 55.4%, short vellus hair (27 patients, 40.9% and tapering hairs (8 patients, 12.1%. Conclusions: The most common dermoscopic finding of AA in our study was yellow dots, followed by black dots, broken hairs, short vellus hair and tapering hairs. Dermoscopic findings were not affected by the type of AA or the severity of the disease.

Patients' Experiences With Vehicle Collision to Inform the Development of Clinical Practice Guidelines: A Narrative Inquiry.

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Lindsay, Gail M; Mior, Silvano A; Côté, Pierre; Carroll, Linda J; Shearer, Heather M

2016-01-01

The purpose of this narrative inquiry was to explore the experiences of persons who were injured in traffic collisions and seek their recommendations for the development of clinical practice guideline (CPG) for the management of minor traffic injuries. Patients receiving care for traffic injuries were recruited from 4 clinics in Ontario, Canada resulting in 11 adult participants (5 men, 6 women). Eight were injured while driving cars, 1 was injured on a motorcycle, 2 were pedestrians, and none caused the collision. Using narrative inquiry methodology, initial interviews were audiotaped, and follow-up interviews were held within 2 weeks to extend the story of experience created from the first interview. Narrative plotlines across the 11 stories were identified, and a composite story inclusive of all recommendations was developed by the authors. The research findings and composite narrative were used to inform the CPG Expert Panel in the development of new CPGs. Four recommended directions were identified from the narrative inquiry process and applied. First, terminology that caused stigma was a concern. This resulted in modified language ("injured persons") being adopted by the Expert Panel, and a new nomenclature categorizing layers of injury was identified. Second, participants valued being engaged as partners with health care practitioners. This resulted in inclusion of shared decision-making as a foundational recommendation connecting CPGs and care planning. Third, emotional distress was recognized as a factor in recovery. Therefore, the importance of early detection and the ongoing evaluation of risk factors for delayed recovery were included in all CPGs. Fourth, participants shared that they were unfamiliar with the health care system and insurance industry before their accident. Thus, repeatedly orienting injured persons to the system was advised. A narrative inquiry of 11 patients' experiences with traffic collision and their recommendations for clinical

Study of diffuse alopecia in females

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Jain V

2000-01-01

Full Text Available One hundred female patients, in the age range of 14-60 years suffering from diffuse hair loss were studied for pattern of aiopecia and probable causes. Pattern of hair loss was of telogen effluvium in 92% patients, androgenetic alopecia in 7% and anagen defluvium in 1%. The probable causes of diffuse alopecia were found to be psychological stress in 30%, fever in 33%, abortion and delivery in 21%, trauma and surgical operation in 13%, and hypothyroidism in 10%. In 57% patients more than two fac-tors, while in 6% no probable cause could be found on the basis of history. Routine laboratory investiga-tions revealed Hb level less than 12gm% in 96% patients, hypochromic picture on PBF examination in 57% patients, GIT parasites in 13% patients on stool examination, T 3 value less than 70 p gm/dl in 7% and TSH more than 7IU in 8 % cases. Mircoscopic examination of hairs in all the cases showed (telogen club root except in one case which showed broken and tapered root end (anagen.

The association of urolithiasis and androgenetic alopecia.

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Resorlu, Mustafa; Sancak, Eyup Burak; Uysal, Fatma; Arslan, Muhammet; Diri, Akif; Adam, Gurhan; Akbas, Alpaslan; Sariyildirim, Abdullah; Gulpinar, Murat Tolga; Resorlu, Berkan

2016-01-01

The objective of this study is to investigate whether patients with androgenetic alopecia were at risk in terms of urinary system stone disease. Patients with no baldness (Hamilton-Norwood Scala [HNS] stage I) were categorized as Group I, those with hair loss in the frontal region (HNS stages II, III, IIIa, and IVa) as Group II, those with hair loss in the vertex region (HNS stage III-vertex, V) as Group III and those with hair loss in both vertex and frontal regions (HNS stages IV, Va, VI, and VII) as Group IV. Patients in all groups were compared in terms of presence of stone, and the presence of any association between alopecia and urolithiasis, with common etiological risk factors, was investigated. Three hundred and two male patients were included in the study. The presence of urolithiasis was detected in 28.9% of patients in Group I; 26.5% of Group II; 36.9% of Group III; and 44.4% of Group IV (p = 0.085). Among patients aged under 60, urinary stone disease was detected in 30.8% of patients in Group I; 26.4% of Group II; 41.2% of Group III; and 53.8% of Group IV (p = 0.001). In patients aged over 60, urolithiasis was detected in 12.5% of patients in Group I; 26.9% of Group II; 32.2% of Group III; and 37.8% of Group IV (p = 0.371). We determined a significant correlation between vertex pattern and total alopecia with urolithiasis in patients younger than 60 years old.

Evaluation of serum homocysteine, high-sensitivity CRP, and RBC folate in patients with alopecia areata

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Maryam Yousefi

2014-01-01

Full Text Available Introduction: Alopecia areata (AA is a common type of hair loss with an autoimmune basis. As the role of homocysteine (Hcys, folate, and CRP has been considered in some autoimmune diseases. Objectives: To evaluate homocysteine, folate and CRP level in AA. Methods: This study was performed on 29 patients who had AA for at least 6 months affecting more than 20% of scalp, and 32 healthy controls. Levels of serum Hcys, blood high-sensitivity CRP, and RBC folate were measured in all subjects. Results: The mean level of RBC folate was significantly lower in the patient group than that in controls (P < 0.001. Also, the level of RBC folate was significantly lower in patients with extensive forms of disease (alopecia totalis/alopecia universalis in comparison with more localized form (patchy hair loss (P < 0.05. Patients with higher "Severity of Alopecia Total" (SALT score had lower RBC folate, as well. Serum Hcys and blood high-sensitivity CRP levels did not show a significant difference in two groups. Conclusion: Patients with alopecia areata have lower level of RBC folate which is in negative correlation with both severity and extension of AA.

The effectiveness of treatments for androgenetic alopecia: A systematic review and meta-analysis.

Science.gov (United States)

Adil, Areej; Godwin, Marshall

2017-07-01

Androgenetic alopecia, or male pattern hair loss, is a hair loss disorder mediated by dihydrotestosterone, the potent form of testosterone. Currently, minoxidil and finasteride are Food and Drug Administration (FDA)-approved, and HairMax LaserComb, which is FDA-cleared, are the only treatments recognized by the FDA as treatments of androgenetic alopecia. This systematic review and meta-analysis assesses the efficacy of nonsurgical treatments of androgenetic alopecia in comparison to placebo for improving hair density, thickness, growth (defined by an increased anagen:telogen ratio), or subjective global assessments done by patients and investigators. A systematic review of randomized controlled trials was conducted. PubMed, Embase, and Cochrane were searched up to December 2016, with no lower limit on the year. We included only randomized controlled trials of good or fair quality based on the US Preventive Services Task Force quality assessment process. A meta-analysis was conducted separately for 5 groups of studies that tested the following hair loss treatments: low-level laser light therapy in men, 5% minoxidil in men, 2% minoxidil in men, 1 mg finasteride in men, and 2% minoxidil in women. All treatments were superior to placebo (P laser light therapy are effective for promoting hair growth in men with androgenetic alopecia and that minoxidil is effective in women with androgenetic alopecia. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Porphyria Cutanea Tarda Presenting with Scleroderma, Ichthyosis, Alopecia, and Vitiligo

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Megan E. MacGillivray

2018-05-01

Full Text Available Porphyria cutanea tarda (PCT is a cutaneous porphyria that presents later in life with cutaneous findings in sun-exposed sites. We report a complex case of PCT in a 67-year-old woman with an unusual constellation of cutaneous findings: scleroderma, acquired ichthyosis, and nonscarring alopecia. Possible triggers for her PCT include tamoxifen treatment for breast cancer and carrier status of the hemochromatosis gene. High-dose chloroquine was used to successfully achieve clinical remission and normalize her uroporphyrins. While on chloroquine she developed extensive classic vitiligo. It is not clear if this is another feature of her complex and unusual PCT, or a consequence of her antimalarial therapy.

FINASTERIDE AS A TREATMENT FOR MALE ANDROGENETIC ALOPECIA

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Ni Komang Tristiana Dewi

2013-04-01

Full Text Available Androgenetic alopecia (AGA is a type of alopecia non sikatrik that most often occur, especially in men. AGA is hereditary baldness and form distinctive patterns. Causes related to AGA estimated serum androgen levels, especially 5-?-dehydrotestosterone (DHT, which can lead to miniaturization of the hair follicle. Finasteride is one of drugs that proven effective in treating hair loss caused by AGA. Finasteride is a 4-azasteroid components that are competitive and specific inhibitor of the enzyme 5-?-reductase type II, an enzyme that converts testosteron into intracellular DHT. By inhibiting the enzyme 5-?-reductase type II, conversion of testosteron to DHT inhibited, thereby causing a significant decrease in serum and tissue DHT concentrations. The use of finasteride 1 mg per day proven to effectively treat AGA in men.  

Therapeutic Effects of Topical Minoxidil or Rosemary and the Combination of Both on the treatment of Alopecia areata

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Mohammad Hossein Lohrasb

2015-02-01

Full Text Available Background & Objectives: Considering the prevalence of Alopecia areata, , failure of treatment, and the unknown pathogenesis of this illness, a comparative study was performed by using topical Minoxidil 2% and topical rosemary solution alone and in combination to treatment this disease. Materials & Methods: This study is a clinical trial performed on 200 patients with Alopecia areata referring to Hamzeh clinic of Fasa during the years 2012 and 2013. They were divided into four groups by random permutation, each group contained 50 patients. Group one received the combination of topical Minoxidil 2% and topical rosemary, group two received only topical Minoxidil 2% solution, group three received only topical rosemary solution and the fourth group, the case-control group, did not receive any medication and were just advised to rub the site of the disease for the same period of time. The patients were under observation for one year. Results: The Results of this investigation showed that the best remissions after treatments were as follow (respectively: combination of topical Minoxidil 2% and topical rosemary (27 patient=54 %, Minoxidil 2% solution (23 patients =46%, rosemary solution (21 patients =42%, and case- control group (9 patients =18%. These results showed that despite better response to the combination of rosemary and Minoxidil solutions in comparison to the two other treated groups, the changes were minimal and statistically insignificant (P-value =0.0411. Conclusion: Using the combination of both rosemary and Minoxidil is more effective than the individual one on treatment of Alopecia areata.

Proposing a clinical quantification framework of macro-linguistic structures in aphasic narratives

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Anthony Pak Hin Kong

2014-03-01

Full Text Available Background Analysis of aphasic narratives can be a challenge for clinicians. Previous studies have mainly employed measures that categorized speech samples at the word level. They included quantification of the use and misuse of different word classes, presence and absence of narrative contents and errors, paraphasias, and perseverations, as well as morphological structures and errors within a narrative. In other words, a great amount of research has been conducted in the aphasiology literature focusing on micro-linguistic structures of oral narratives. Aspects of macro- linguistic structures, such as the analysis of content information by a speaker, consistency of using cohesive devices to present information within a narrative, and order of presenting information necessary to form a coherent discourse, have not been extensively investigated. The current investigation proposes a clinical analytic system to target three aspects of macro-linguistic structures in narratives among speakers with aphasia. Specifically, (1 the presence of search events (i.e., the mentioning of key events that allow the listener to understand; Capilouto, Wright, &Wagovich, 2006 within a narrative, (2 the sequence of the mentioned events, and (3 the informativeness (i.e., the fulfillment of lexical items that allow the user to understand what the event is detailing of the event contents, were focused in the proposed framework. Method Ten controls transcripts from were selected from the AphasiaBank (MacWhinney, Fromm, Forbes, & Holland, 2011. Three narrative tasks, including sequential picture description of ‘Refused Umbrella’, procedural narrative of making a ‘Peanut Butter and Jelly Sandwich’, and telling of ‘Cinderella’ story, were used to establish normative data for the basis of analysis. Specifically, the Search Events (e and Informative Words (i used by at least 70% of the speakers were listed for each genre. The sequential order of mentioning the

Alopecia areata: medical treatments

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Zonunsanga

2015-01-01

Full Text Available Alopecia areata (AA is a non-scarring, autoimmune, inflammatory, relapsing hair loss affecting the scalp and/or body. In acute-phase AA, CD4+ and CD8+ T cells infiltrated in the juxta-follicular area. In chronic-phase AACD8+ T cells dominated the infiltrate around hair bulbs which contributes to the prolonged state of hair loss. Treatments include mainly corticosteroids, topical irritants, minoxidil, cytotoxic drugs and biologicals. This review highlights mainly the pathomechanism and pathology, classifications and associated diseases with regard to their importance for current and future treatment.

Narrating psychological distress

DEFF Research Database (Denmark)

Zinken, Jörg; Blakemore, Caroline; Zinken, Katarzyna

2011-01-01

Psychological research has emphasized the importance of narrative for a person's sense of self. Building a coherent narrative of past events is one objective of psychotherapy. However, in guided self-help therapy the patient has to develop this narrative autonomously. Identifying patients......' narrative skills in relation to psychological distress could provide useful information about their suitability for self-help. The aim of this study was to explore whether the syntactic integration of clauses into narrative in texts written by prospective psychotherapy patients was related to mild...... to moderate psychological distress. Cross-clausal syntax of texts by 97 people who had contacted a primary care mental health service was analyzed. Severity of symptoms associated with mental health difficulties was assessed by a standardized scale (Clinical Outcomes in Routine Evaluation outcome measure...

Effect of petroleum ether and ethanol fractions of seeds of Abrus precatorius on androgenic alopecia

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Sukirti Upadhyay

2012-04-01

Full Text Available Seeds of Abrus precatorius L., Fabaceae, are commonly used as purgative, emetic, aphrodisiac and in nervous disorder in traditional and folk medicines. In present study petroleum ether and ethanolic extracts of A. precatorius seeds are evaluated for reversal of androgen (testosterone by i.m route induced alopecia in male albino wistar rats and compared to topical administration of standard antiandrogenic drug finasteride for 21 days. The results were reflected from visual observation and histological study of several skin sections via various parameters as anagen to telogen ratio and follicle density/mm area of skin surface. The animal of group 1 who were treated with only testosterone became alopecic on visual observation. Animals of Group 2, 3 and 4 who were treated with finasteride, petroleum ether and ethanolic extract of seed respectively topically along with testosterone (i.m did not developed alopecia. To investigate the mechanism of observed activity, in vitro experiments were performed. Inhibition of 5α-reductase activity by extracts and finasteride suggest that they reversed androgen induced alopecia by inhibiting conversion of testosterone to dihydrotestosterone (potent androgen responsible for androgenic alopecia. So it may be concluded that petroleum ether and ethanolic extract of A. precatorius seed posses anti androgenic alopecia activity due to inhibition of 5α-reductase enzyme.

Effect of petroleum ether and ethanol fractions of seeds of Abrus precatorius on androgenic alopecia

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Sukirti Upadhyay

2011-12-01

Full Text Available Seeds of Abrus precatorius L., Fabaceae, are commonly used as purgative, emetic, aphrodisiac and in nervous disorder in traditional and folk medicines. In present study petroleum ether and ethanolic extracts of A. precatorius seeds are evaluated for reversal of androgen (testosterone by i.m route induced alopecia in male albino wistar rats and compared to topical administration of standard antiandrogenic drug finasteride for 21 days. The results were reflected from visual observation and histological study of several skin sections via various parameters as anagen to telogen ratio and follicle density/mm area of skin surface. The animal of group 1 who were treated with only testosterone became alopecic on visual observation. Animals of Group 2, 3 and 4 who were treated with finasteride, petroleum ether and ethanolic extract of seed respectively topically along with testosterone (i.m did not developed alopecia. To investigate the mechanism of observed activity, in vitro experiments were performed. Inhibition of 5α-reductase activity by extracts and finasteride suggest that they reversed androgen induced alopecia by inhibiting conversion of testosterone to dihydrotestosterone (potent androgen responsible for androgenic alopecia. So it may be concluded that petroleum ether and ethanolic extract of A. precatorius seed posses anti androgenic alopecia activity due to inhibition of 5α-reductase enzyme.

Clinicoepidemiological Observational Study of Acquired Alopecias in Females Correlating with Anemia and Thyroid Function

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Kirti Deo

2016-01-01

Full Text Available Alopecia can either be inherited or acquired; the latter, more common, can be diffuse, patterned, and focal, each having cicatricial and noncicatricial forms. This observational study of 135 cases in a semiurban Indian population aimed to detect the prevalence of various forms of acquired alopecia in females and correlate the same with levels of hemoglobin, serum ferritin, triiodothyronine, thyroxin, and thyroid stimulating hormone. The majority (84, 62.2% of our cases of alopecia had telogen effluvium followed by female pattern alopecia (32, 23.7%. Stress (86, 63.7%, topical application of chemicals (72, 53.3%, systemic medications for concurrent illnesses (62, 5%, and pregnancy (14, 10.3% were the common exacerbating factors. Neither low hemoglobin (12 μg/L. Though lack of vitamin B12 testing was a limitation of our study, its deficiency could be the probable cause of iron deficiency as the majority (58, 64.4% of these cases, as indeed majority (89, 65.4% of our study population, were vegetarians. Thyroid disorders (23, 17%, including 9 newly diagnosed were not of significance statistically.

Alopecia areata and vitiligo as primary presentations in a young male with human immunodeficiency virus

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Li Xuan

2014-01-01

Full Text Available A 26-year-old Chinese male consulted with the team regarding his alopecia areata and vitiligo for which previous treatment was ineffective. The patient, a homosexual man, denied having a history of drug abuse and of blood transfusion. No member of his family had vitiligo or alopecia. Laboratory studies revealed that the serum for anti-human immunodeficiency virus (HIV antibody was positive. The patient′s CD4 lymphocyte count and CD4/CD8 ratio were both strikingly low (20 cells/mL and 0.04, but no other complaints or opportunistic infections were reported. One month after antiretroviral therapy, the patient′s alopecia areata dramatically improved, but no evident improvement in his vitiligo was found. This case is a very rare case of alopecia areata and vitiligo associated with HIV infection that might be attributed to the generation and maintenance of self-reactive CD8+ T-cells due to chronic immune activation with progressive immune exhaustion in HIV infection.

Relationship between irreversible alopecia and exposure to cyclophosphamide, thiotepa and carboplatin (CTC) in high-dose chemotherapy

NARCIS (Netherlands)

de Jonge, M. E.; Mathôt, R. A. A.; Dalesio, O.; Huitema, A. D. R.; Rodenhuis, S.; Beijnen, J. H.

2002-01-01

Reversible alopecia is a commonly observed, important and distressing complication of chemotherapy. Permanent alopecia, however, is rare after standard-dose therapy, but has occasionally been observed after high-dose chemotherapy with cyclophosphamide, thiotepa and carboplatin (CTC). We evaluated

Narrative thematic analysis of baccalaureate nursing students' reflections: critical thinking in the clinical education context.

Science.gov (United States)

Naber, Jessica L; Hall, Joanne; Schadler, Craig Matthew

2014-09-01

This study sought to identify characteristics of clinically situated critical thinking in nursing students' reflections, originally part of a study guided by Richard Paul's model of critical thinking. Nurses are expected to apply critical thinking in all practice situations to improve health outcomes, including patient safety and satisfaction. In a previous study, Paul's model of critical thinking was used to develop questions for reflective writing assignments. Within that study, 30 nursing students completed six open-ended narratives of nurse-patient clinical encounters during an 8-week period. Improvements were seen in critical thinking scores after the intervention. This article reports the qualitative analysis of the content of six open-ended narratives. Six overarching themes were identified and combined into a tentative conceptual model. Faculty's understanding of the characteristics of critical thinking in the context of clinical education will help them to teach and evaluate students' progress and competencies for future practice.

Evaluation of clinical significance of dermoscopy in alopecia areata

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Akhila Sai Guttikonda

2016-01-01

Full Text Available Background: Alopecia areata (AA is a common, chronic inflammatory disease characterized by nonscarring hair loss on the scalp or any hair-bearing area of the body. Recently, dermoscopy, a noninvasive diagnostic procedure, has been employed for the diagnosis of AA. Aim: To evaluate various dermoscopic patterns in AA and correlate these patterns with the disease activity and severity. Materials and Methods: Dermoscopy was performed on AA patients using DL1 dermoscope (magnification ×10 was used. The dermoscopic patterns recorded were analyzed to identify any correlation with the disease activity and severity. Results: A total of fifty patients of AA were recruited in the study. Female outnumbered males with the ratio being 1.173:1. Mean age of the patients was 25.06 years. Mean duration of disease was 14 months. The most common site involved was scalp (80% and type noted was patchy (84%. Various dermoscopic patterns noted were yellow dots (YD (88%, short vellus hair (66%, black dots (BD (58%, broken hairs (BHs (56%, tapering hair (TH (26%, Coudability hairs (14%, pigtail hair (14%, and Pohl-Pinkus constrictions (2%. Statistically significant correlation was observed between BD, BHs, THs, and disease activity. No significant correlation was found between severity and any of the dermoscopic features. Conclusion: The most common dermoscopic pattern in our study was YD. Presence of BDs, BHs, and THs indicate active disease. Dermoscopic patterns were not affected by severity of the disease.

Low-level laser/light therapy for androgenetic alopecia.

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Gupta, Aditya K; Lyons, Danika C A; Abramovits, William

2014-01-01

Androgenetic alopecia (AGA) is a persistent and pervasive condition that affects men worldwide. Some common treatment options for AGA include hair prosthetics, oral and topical medications, and surgical hair restoration (SHR). Pharmaceutical and SHR treatments are associated with limitations including adverse side effects and significant financial burden. Low-level laser or light (LLL) devices offer alternative treatment options that are not typically associated with adverse side effects or significant costs. There are clinic- and home-based LLL devices. One home-based laser comb device has set a standard for others; however, this device requires time devoted to carefully moving the comb through the hair to allow laser penetration to the scalp. A novel helmet-like LLL device for hair growth has proven effective in preliminary trials and allows for hands-free use. Regardless, there are few clinical trials that have been conducted regarding LLL devices for AGA and results are mixed. Further research is required to establish the true efficacy of these devices for hair growth in comparison to existing alternative therapies.

What about narrative dentistry?

Science.gov (United States)

Vergnes, Jean-Noel; Apelian, Nareg; Bedos, Christophe

2015-06-01

Narrative medicine strives toward a humanized form of medicine in which empathy and the ability to listen are developed with the same emphasis as scientific rigor. We hypothesize that the adoption of narrative medicine in dentistry would be an excellent method to cultivate the philosophy behind the emerging clinical concept of patient-centered dentistry. Reading literary works, reflective writing, and creative writing would sensitize practitioners to the daily lives of people, human uniqueness, and alterity. Narrative dentistry could lead to more empathic and self-aware practices, and improve dental professionals' observational abilities by making them more perceptive and more attentive to image, metaphor, and meaning. The introduction of narrative dentistry would enrich the clinical clerkship of dentists by bringing the often-missing humanities to the dental professional, academic, and scientific environment. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

Can long-term alopecia occur after appropriate pulsed-dye laser therapy in hair-bearing sites? Pediatric dermatologists weigh in.

Science.gov (United States)

Feldstein, Stephanie; Totri, Christine R; Friedlander, Sheila F

2015-03-01

The risk of long-term alopecia after pulsed-dye laser (PDL) therapy is unknown. To identify how many practitioners treat hair-bearing sites with PDL and how commonly long-term alopecia occurs, the authors queried pediatric dermatologists about their experiences using this modality. A survey was designed to evaluate the frequency of and factors contributing to long-term alopecia after PDL treatment of port-wine stains (PWS). "Long-term" was defined as no sign of hair regrowth after several years of nontreatment. The survey was administered to attendees at the 2014 Society for Pediatric Dermatology biannual meeting. Sixty-four pediatric dermatologists completed the survey, 50 of whom had experience using PDL. Of these physicians, 86% have used PDL to treat PWS of the eyebrow and 80% have treated PWS of the scalp. Over one-quarter of respondents (25.5%) using PDL on hair-bearing areas had at least 1 of their patients develop long-term alopecia after PDL treatment. The incidence of long-term alopecia after PDL treatment in the surveyed population was 1.5% to 2.6%. The occurrence of long-term alopecia at hair-bearing sites after treatment with PDL may be greater than previously thought. Because the majority of physicians using PDL treat hair-bearing areas, prospective studies are needed to more accurately determine the risk of long-term alopecia and the factors that contribute to it.

Female pattern alopecia: current perspectives

Science.gov (United States)

Levy, Lauren L; Emer, Jason J

2013-01-01

Hair loss is a commonly encountered problem in clinical practice, with men presenting with a distinctive pattern involving hairline recession and vertex balding (Norwood-Hamilton classification) and women exhibiting diffuse hair thinning over the crown (increased part width) and sparing of the frontal hairline (Ludwig classification). Female pattern hair loss has a strikingly overwhelming psychological effect; thus, successful treatments are necessary. Difficulty lies in successful treatment interventions, as only two medications – minoxidil and finasteride – are approved for the treatment of androgenetic alopecia, and these medications offer mediocre results, lack of a permanent cure, and potential complications. Hair transplantation is the only current successful permanent option, and it requires surgical procedures. Several other medical options, such as antiandrogens (eg, spironolactone, oral contraceptives, cyproterone, flutamide, dutasteride), prostaglandin analogs (eg, bimatoprost, latanoprost), and ketoconazole are reported to be beneficial. Laser and light therapies have also become popular despite the lack of a profound benefit. Management of expectations is crucial, and the aim of therapy, given the current therapeutic options, is to slow or stop disease progression with contentment despite patient expectations of permanent hair regrowth. This article reviews current perspectives on therapeutic options for female pattern hair loss. PMID:24039457

Androgenetic, diffuse and senescent alopecia in men: practical evaluation and management.

Science.gov (United States)

Torres, Fernanda

2015-01-01

Male baldness is the most common diagnosis in men that present with hair loss. It is a genetically determined condition that is clearly an androgen-dependent trait, mainly driven by dihydrotestosterone action on the hair follicles, leading to miniaturization. Although in general this condition is socially accepted as a natural process in a man's life, for some individuals it might significantly impact quality of life, reducing self-esteem and increasing stress. This chapter encompasses the most important aspects of the practical evaluation (clinical features, trichoscopy, trichogram, histopathology, relevant blood tests) and management of male baldness, diffuse baldness and senescent alopecia. © 2015 S. Karger AG, Basel.

Low-energy laser in the treatment of alopecia of the scalp

Science.gov (United States)

Ciuchita, Tavi; Usurelu, Mircea; Antipa, Ciprian

1997-12-01

The authors tried to verify the efficacy of low energy laser (LEL) in scalp alopecia. Sixty patients were divided in two groups: A) laser group, 33 patients treated with both LEL and classical therapy; B) control group, 27 patients treated only with classical therapy, Before, during and after treatment, historical samples were done. For the group A the results were rather superior but in a twice shorter time shorter time than group B. The maintenance of the good results needed classical therapy for a long period. We conclude that LEL therapy could have a useful complementary method for the treatment of scalp alopecia.

EFFICACY OF LOW LEVEL LASER THERAPY IN THE TREATMENT OF ALOPECIA AREATA

OpenAIRE

Nermeen Mohamed Abdelhalim. PhD PT

2014-01-01

Background: Alopecia areata is a chronic inflammatory disease which affects the hair follicles and sometimes the nails. Purpose: The purpose of this study was to evaluate the efficacy of low level laser therapy in the treatment of alopecia areata of the scalp. Method: Twenty three patients (14 male and 9 female) had 2 or more patches of the scalp, one patch was left for comparison as a control patches. The age ranged from 22 to 39 years with 30 ± 6.09 years mean. The study p...

Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men

NARCIS (Netherlands)

Blumeyer, Anja; Tosti, Antonella; Messenger, Andrew; Reygagne, Pascal; del Marmol, Veronique; Spuls, Phyllis I.; Trakatelli, Myrto; Finner, Andreas; Kiesewetter, Franklin; Trüeb, Ralph; Rzany, Berthold; Blume-Peytavi, Ulrike

2011-01-01

Androgenetic alopecia is the most common hair loss disorder, affecting both men and women. Initial signs of androgenetic alopecia usually develop during teenage years leading to progressive hair loss with a pattern distribution. Moreover, its frequency increases with age and affects up to 80 %

Improving Layman Readability of Clinical Narratives with Unsupervised Synonym Replacement.

Science.gov (United States)

Moen, Hans; Peltonen, Laura-Maria; Koivumäki, Mikko; Suhonen, Henry; Salakoski, Tapio; Ginter, Filip; Salanterä, Sanna

2018-01-01

We report on the development and evaluation of a prototype tool aimed to assist laymen/patients in understanding the content of clinical narratives. The tool relies largely on unsupervised machine learning applied to two large corpora of unlabeled text - a clinical corpus and a general domain corpus. A joint semantic word-space model is created for the purpose of extracting easier to understand alternatives for words considered difficult to understand by laymen. Two domain experts evaluate the tool and inter-rater agreement is calculated. When having the tool suggest ten alternatives to each difficult word, it suggests acceptable lay words for 55.51% of them. This and future manual evaluation will serve to further improve performance, where also supervised machine learning will be used.

The role of inflammation and immunity in the pathogenesis of androgenetic alopecia.

Science.gov (United States)

Magro, Cynthia M; Rossi, Anthony; Poe, Jonathan; Manhas-Bhutani, Suveena; Sadick, Neil

2011-12-01

Female pattern hair loss affects many women; its pathogenetic basis has been held to be similar to men with common baldness. The objective of this study was to determine the role of immunity and inflammation in androgenetic alopecia in women and modulate therapy according to inflammatory and immunoreactant profiles. 52 women with androgenetic alopecia (AA) underwent scalp biopsies for routine light microscopic assessment and direct immunofluroescent studies. In 18 patients, serologic assessment for antibodies to androgen receptor, estrogen receptor and cytokeratin 15 was conducted. A lymphocytic folliculitis targeting the bulge epithelium was observed in many cases. Thirty-three of 52 female patients had significant deposits of IgM within the epidermal basement membrane zone typically accompanied by components of complement activation. The severity of changes light microscopically were more apparent in the positive immunoreactant group. Biopsies from men with androgenetic alopecia showed a similar pattern of inflammation and immunoreactant deposition. Serologic assessment for antibodies to androgen receptor, estrogen receptor or cytokeratin 15 were negative. Combined modality therapy with minocycline and topical steroids along with red light produced consistent good results in the positive immunoreactant group compared to the negative immunoreactant group. A lymphocytic microfolliculitis targeting the bulge epithelium along with deposits of epithelial basement membrane zone immunoreactants are frequent findings in androgenetic alopecia and could point toward an immunologically driven trigger. Cases showing a positive immunoreactant profile respond well to combined modality therapy compared to those with a negative result.

Novel Approach to Treating Androgenetic Alopecia in Females With Photobiomodulation (Low-Level Laser Therapy).

Science.gov (United States)

Friedman, Shelly; Schnoor, Patricia

2017-06-01

Photobiomodulation, also referred to as low-level laser therapy (LLLT), has been studied and used for (among other diseases) the promotion of hair regrowth. A clinical study was developed to define the physiologic effects that occur when the human hair follicle and surrounding tissue structures are exposed to laser light using a novel device that is fitted with an array of laser diode sources operating at 650 nm and placed inside a sports cap to promote discretion while in use. The study demonstrates that low-level laser treatment of the scalp every other day for 17 weeks using the HANDI-DOME LASER device is a safe and effective treatment for androgenetic alopecia in healthy females between the ages of 18 to 60 with Fitzpatrick skin Types I to IV and Ludwig-Savin Baldness Scale I-2 to II-2 baldness patterns. Subjects receiving LLLT at 650 nm achieved a 51% increase in hair counts as compared with sham-treated control patients in this multicenter randomized controlled trial. These results suggest that the emerging technology of low-level laser therapy may play a potentially significant role in health care providers' armamentarium for the disease androgenic alopecia.

THE ROLE OF FOLLICULAR UNIT GRAFTING IN TREATMENT ALOPECIA

Directory of Open Access Journals (Sweden)

Duhita Ayuningtyas

2013-07-01

Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Alopecia is usually treatable and self-limited, but it may be permanent. Careful diagnosis of the type of hair loss will aid in selecting effective treatment. Many drugs used to treat alopecia, but in many people not satisfied with the result. One of the treatment currently used to treat alopecia is hair transplantation with follicular unit grafting (FUG. The advantages of hair transplantation is to create a natural appearance, one that mimics natural hair growth both in terms of numbers and pattern /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

MARKETING RESEARCHES OF MEDICINAL AND COSMETIC REMEDIES INTENDED FOR APPLYING IN VARIOUS FORMS OF ALOPECIA

Directory of Open Access Journals (Sweden)

I. O. Yarema

2014-12-01

Full Text Available Pathological hair loss – alopecia – is an urgent problem that takes one of the leading places in the pathology of skin structure. There are different types of alopecia, the most common forms are androgen and telogen (symptomatic alopecia. Androgenic alopecia (AA isa progressive alopecia caused by androgens action on hair follicle in patients with hereditary predisposition, which is often manifested not only with excessive hair loss, but also with the appearance of dandruff. Uncontrolled use of cosmetic products for combating hair loss is increased in view of high prevalence among young people, and as advertising in the media. Therefore, an important task of modern pharmacy is to create a medicinal remedy that contribute efficient and controlled correction of AA and provide the pharmaceutical market of Ukraine with available economical means. The significant range of cosmetics and medicinal products to eliminate dandruff and hair loss correctionare implementedin Ukraine pharmacy network today. However, the amount of medicinal remedy decreases every year. Most of them, after re-registration movetothe category of cosmeceuticals.This cause the significant increase in the value. For example, the number of medicinal remedy registered in Ukraine for local and systemic treatment of alopecia compared with 2012 decreased approximately on 36%, and drugs to treat dandruff - 17%. Today the amount of native medicines for the treatment of alopecia and dandruff is limited and is only 23%, compared with foreign firms. Leading positions in the import medicines of this group are occupied by India, Germany and France, and the share of foreign drugs is 77% from the total. Cosmetic hair loss remedies are presented significantly numerous, compared to medicinal remedy, an arsenal of forms production, including shampoos, masks, lotions, oil, balms, solutions for rubbing into the scalp, capsules for internal use and so on. The main components of active cosmeceuticals

Impact of scalp cooling on chemotherapy-induced alopecia, wig use and hair growth of patients with cancer

NARCIS (Netherlands)

van den Hurk, C.J.; van den Akker-van Marle, E.M.; Breed, W.P.M.; van de Poll-Franse, L.V.; Nortier, J.; Coebergh, J.W.W.

2013-01-01

Introduction Cytotoxic therapy for patients with cancer frequently induces reversible, but long-lasting alopecia which might be prevented by scalp cooling. This study evaluates the effectiveness of scalp cooling with respect to the severity of chemotherapy-induced alopecia (CIA) and the purchase and

Characteristics of Androgenetic Alopecia in Asian

OpenAIRE

Lee, Won-Soo; Lee, Hae-Jin

2012-01-01

Androgenetic alopecia (AGA), or pattern hair loss, is a common disorder in Asian men and women, with a reported incidence of up to 73% among general population. There are several descriptions regarding the characteristics of AGA in patients of European descent. Asian patients with AGA have different types of hair loss and family histories from Europeans, which may affect treatment response. Therefore, in this review, prevalence, hair loss patterns, familial factors, androgen receptor gene pol...

[Alopecia areata: a retrospective study of the paediatric dermatology department (2000-2008)].

Science.gov (United States)

Rocha, Joana; Ventura, Filipa; Vieira, Ana Paula; Pinheiro, Ana Raquel; Fernandes, Susana; Brito, Celeste

2011-01-01

Alopecia areata usually presents as patchy, nonscarring hair loss. It seems to be an immune mediated disease, whereas genetic predisposition, environmental and psychological triggers may be involved in its aetiology. To study the epidemiology, clinical aspects, associations, and treatment of alopecia areata in the paediatric population of Peadiatric Dermatology outpatients over a 9-year period. Some psychologic characteristics were also assessed. Descriptive and retrospective study of all newly diagnosed AA cases seen from January 2000 to December 2008 at the Hospital de São Marcos' Paediatric Dermatology Department. Fifteen patients with AA were interviewed for psycologic evaluation. Forty-eight cases (54% male/46% female) were identified. Mean age at presentation was 7.8 years. Family history of AA was reported in 10% of the cases, and in 25% there was a personal and/or family history of atopy. The majority of patients (82%) had mild disease and topical corticotherapy was the first-line treatment for limited AA. Fifty-four percent of these patients had a complete resolution of the lesions with treatment. Systemic treatment (corticosteroids and/or ciclosporin) was used in 71% of patients with extensive disease (more than 50% hair loss). Only one of these patients had a sustained clinical improvement after treatment. Twelve out of 15 respondents (80%) recalled stressful events preceding hair loss. Our findings are similar to those reported in other studies. Epidemiologic studies of AA are available in adulthood but there is a paucity of literature on children with AA. A holistic approach is important in the management of childhood AA as the disease can have a severe psychologic impact on an individual's well-being.

Genetic analysis of interleukin 18 gene polymorphisms in alopecia areata.

Science.gov (United States)

Celik, Sumeyya Deniz; Ates, Omer

2018-06-01

Alopecia areata (AA), which appears as nonscarring hair shedding on any hair-bearing area, is a common organ-specific autoimmune condition. Cytokines have important roles in the development of AA. Interleukin (IL) 18 is a significant proinflammatory cytokine that was found higher in the patients with AA. We aimed to investigate whether the IL-18 (rs187238 and rs1946518) single nucleotide polymorphisms (SNPs) may be associated with AA and/or clinical outcome of patients with AA in Turkish population. Genotyping of rs187238 and rs1946518 SNPs were detected using sequence-specific primer-polymerase chain reaction (SSP-PCR) method in 200 patients with AA and 200 control subjects. The genotype distribution of rs1946518 (-607C>A) SNP was found to be statistically significantly different among patients with AA and controls (P = .0008). Distribution of CC+CA genotypes and frequency of -607/allele C of rs1946518 SNP were higher in patients with AA (P = .001, P = .001, respectively). The genotype distribution of rs187238 (-137G>C) SNP was found to be statistically significantly different among patients with AA and control subjects (P = .0014). Distribution of GG genotype and frequency of -137/allele G of rs187238 SNP were higher in patients with AA (P = .0003, P = .001, respectively). The rs1946518 (-607C>A) and rs187238 (-137G>C) polymorphisms were found associated with alopecia areata disease. The study suggests that IL-18 rs187238 and rs1946518 SNPs may be the cause of the AA susceptibility. © 2018 Wiley Periodicals, Inc.

Narrative ethics for narrative care.

Science.gov (United States)

Baldwin, Clive

2015-08-01

Narrative permeates health care--from patients' stories taken as medical histories to the development of health policy. The narrative approach to health care has involved the move from narratives in health care as objects of study to the lens through which health care is studied and, more recently, to narrative as a form of care. In this paper, I argue that narrative care requires a move in the field of ethics--from a position where narratives are used to inform ethical decision making to one in which narrative is the form and process of ethical decision making. In other words, I argue for a narrative ethics for narrative care. The argument is relatively straightforward. If, as I argue, humans are narrative beings who make sense of themselves, others, and the world in and through narrative, we need to see our actions as both narratively based and narratively contextual and thus understanding the nature, form, and content of the narratives of which we are a part, and the process of narrativity, provides an intersubjective basis for ethical action. Copyright © 2015 Elsevier Inc. All rights reserved.

Trilostane Treatment of Canine Alopecia X in an American Pit Bull Terrier

Directory of Open Access Journals (Sweden)

J. Kolevská

2007-01-01

Full Text Available This paper describes the case of a one-year-old female American Pit Bull Terrier, presented with the history of progressive baldness. The initial clinical signs were demonstrated by symmetric, primarily non-pruritic alopecia that began in the perineal, genital, and ventral abdominal regions and propagated cranially to the thorax and to the neck. Based on physical and dermatological examination, laboratory findings, and results of skin biopsy, a hormone-responsive dermatosis was diagnosed. Once hypothyroidism and hyperadrenocorticism were ruled out, with the help of hormonal tests, the diagnosis was specified as alopecia X. The first treatment option recommended for the patient and subsequently completed was ovariohysterectomy. After three months, the owner reported improvement; the dog was almost covered with hair. The patient was presented again six months later, showing almost the same dermatological symptoms, which, however, were of a more striking character than before ovariohysterectomy. Again a series of hormonal tests was carried out. Considering the elevated basal and post-adrenocorticothropin stimulation progesterone concentrations, the final aetiology of the disease was determined as an adrenal sex hormone imbalance. Therefore trilostan therapy was initiated. The trilostan dosage of 8 mg/kg/day was divided and given 2 times daily. This treatment led to complete hair regrowth in the dog within four months. No adverse effects associated with trilostane were recognized.

An evaluation of PUVA-therapy for alopecia areata

NARCIS (Netherlands)

van der Schaar, W. W.; Sillevis Smith, J. H.

1984-01-01

30 patients with alopecia areata were treated with 8-methoxypsoralen orally combined with whole body UVA exposure. 9 patients showed more than 60% regrowth of hair, 8 of them had recurrences of hair loss within a mean time of 7.7 months. No selecting criteria could be found prophesying good results

Effect of minoxidil on hair transplantation in alopecia androgenetica

Directory of Open Access Journals (Sweden)

Singh Gurinderjit

1998-01-01

Full Text Available Forty patients suffering from androgenetic alopecia were given 3 to 4 sittings of hair transplantation at an interval of 4 to 6 weeks each. Only patients of type III, type III(vertex and type IV baldness were operated. Twenty patients, six of type III, six of type III(vertex and eight of type IV baldness were advised to use minoxidil 2% locally at the recipient area in the dose of 1 ml applied twice daily. Twenty patients of similar types of baldness were advised to just shampoo their hair daily without using topical minoxidil. Percentage of response was compared between the two groups. Minoxidil did not play any role in the percentage of hair survival before and after transplantation in androgenetic alopecia. However in 60percent grafts of patients who had used topical minoxidil, there was no initial postoperative hair shedding.

Pistas dermatoscópicas para diferenciar a tricotilomania da alopecia areata em placa

OpenAIRE

Abraham,Leonardo Spagnol; Torres,Fernanda Nogueira; Azulay-Abulafia,Luna

2010-01-01

INTRODUÇÃO: Tricotilomania e alopecia areata em placa possuem características clínicas e dermatoscópicas semelhantes. OBSERVAÇÕES: O exame dermatoscópico da tricotilomania revela densidade capilar diminuída, cabelos fraturados em diferentes tamanhos, enovelados e vellus, tricoptilose, pontos amarelos com ou sem pontos pretos e ausência de cabelos em "ponto de exclamação". CONCLUSÃO: No contexto de alopecia em placa e cabelos fraturados, a ausência de "pontos de exclamação" sugere o diagnóstic...

HLA-DP antigens in patients with alopecia areata

DEFF Research Database (Denmark)

Ødum, Niels; Morling, N; Georgsen, J

1990-01-01

The distribution of HLA-DP antigens were studied in 41 patients with alopecia areata (AA) and 188 ethnically matched controls. An increase of DR4 and possibly DR5 in 24 of these patients has previously been reported. HLA-DP typing for DPw1 through w6 and the local specificity, CDP HEI, was perfor...

Acquired alopecia, mental retardation, short stature, microcephaly, and optic atrophy

NARCIS (Netherlands)

Hennekam, R. C.; Renckens-Wennen, E. G.

1990-01-01

We report on a female patient who had acquired total alopecia, short stature, microcephaly, optic atrophy, severe myopia, and mental retardation. A survey of published reports failed to show an identical patient, despite various similar cases

Properties of the Narrative Scoring Scheme Using Narrative Retells in Young School-Age Children

Science.gov (United States)

Heilmann, John; Miller, Jon F.; Nockerts, Ann; Dunaway, Claudia

2010-01-01

Purpose: To evaluate the clinical utility of the narrative scoring scheme (NSS) as an index of narrative macrostructure for young school-age children. Method: Oral retells of a wordless picture book were elicited from 129 typically developing children, ages 5-7. A series of correlations and hierarchical regression equations were completed using…

Male-pattern alopecia and masculinity.

Science.gov (United States)

Burton, J L; Halim, M M; Meyrick, G; Jeans, W D; Murphy, D

1979-05-01

Cutaneous processes which are thought to be influenced by androgenic stimulation include the development of male-pattern alopecia, terminal hair distribution, sebum excretion rate, maximal sweat secretion rate and skin thickness. We measured these indices in forty-eight normal men, together with muscle, fat and bone thickness and plasma testosterone. There was a significant correlation between hair density on the forearm, leg and chest, but no other significant correlations were found. We conclude that bald men are no more 'masculine' than those with good scalp hair growth, if masculinity is defined in terms of end-organ response to androgenic stimulation.

A mixed methods survey of social anxiety, anxiety, depression and wig use in alopecia

OpenAIRE

Montgomery, K.; White, C.; Thompson, A. R.

2017-01-01

Objectives This study aimed to examine levels of social anxiety, anxiety and depression reported by people with alopecia as a result of a dermatological condition and associations with wig use. The study also sought to report on experiences of wearing wigs in social situations and the relationship with social confidence.\\ud \\ud Design A cross-sectional survey was sent by email to the Alopecia UK charity mailing list and advertised on social media.\\ud \\ud Participants Inclusion criteria were a...

Effects of alopecia on body image and quality of life of Turkish cancer women with or without headscarf.

Science.gov (United States)

Erol, Ozgul; Can, Gulbeyaz; Aydıner, Adnan

2012-10-01

The aim of this study was to find out the effects of chemotherapy-related alopecia on body image and quality of life of Turkish women who have cancer with or without headscarves and factors affecting them. This descriptive study was conducted with 204 women who received chemotherapy at the Istanbul University Institute of Oncology, Turkey. The Patient Description Form, Body Image Scale and Nightingale Symptom Assessment Scale were used in data collection. Statistical analyses were performed using descriptive statistics and non-parametric tests. Logistic regression analysis was done to predict the factors affecting body image and quality of life of the patients. No difference was found between women wearing headscarves and those who did not in respect of their body image. However, women who wore headscarves who had no alopecia felt less dissatisfied with their scars, and women not wearing headscarves who had no alopecia have been feeling less self-conscious, less dissatisfied with their appearance. There was difference in terms of quality of life: women wearing headscarves had worse physical, psychological and general well-being than others. Although there were many important factors, multivariate analysis showed that for body image, having alopecia and wearing headscarves; and for quality of life, having alopecia were the variables that had considerable effects.

Clinical effects of non-ablative and ablative fractional lasers on various hair disorders: a case series of 17 patients.

Science.gov (United States)

Cho, Suhyun; Choi, Min Ju; Zheng, Zhenlong; Goo, Boncheol; Kim, Do-Young; Cho, Sung Bin

2013-04-01

Both ablative and non-ablative fractional lasers have been applied to various uncommon hair disorders. The purpose of this study was to demonstrate the clinical effects of fractional laser therapy on the course of primary follicular and perifollicular pathologies and subsequent hair regrowth. A retrospective review of 17 patients with uncommon hair disorders - including ophiasis, autosomal recessive woolly hair/hypotrichosis, various secondary cicatricial alopecias, pubic hypotrichosis, frontal fibrosing alopecia, and perifolliculitis abscedens et suffodiens - was conducted. All patients had been treated with non-ablative and/or ablative fractional laser therapies. The mean clinical improvement score in these 17 patients was 2.2, while the mean patient satisfaction score was 2.5. Of the 17 subjects, 12 (70.6%) demonstrated a clinical response to non-ablative and/or ablative fractional laser treatments, including individuals with ophiasis, autosomal recessive woolly hair/hypotrichosis, secondary cicatricial alopecia (scleroderma and pressure-induced alopecia), frontal fibrosing alopecia, and perifolliculitis abscedens et suffodiens. Conversely, patients with long-standing ophiasis, surgical scar-induced secondary cicatricial alopecia, and pubic hypotrichosis did not respond to fractional laser therapy. Our findings demonstrate that the use of non-ablative and/or ablative fractional lasers promoted hair growth in certain cases of uncommon hair disorders without any remarkable side effects.

How to tell a patient's story? Influence of the case narrative design on the clinical reasoning process in virtual patients.

Science.gov (United States)

Hege, Inga; Dietl, Anita; Kiesewetter, Jan; Schelling, Jörg; Kiesewetter, Isabel

2018-02-28

Virtual patients (VPs) are narrative-based educational activities to train clinical reasoning in a safe environment. Our aim was to explore the influence of the design of the narrative and level of difficulty on the clinical reasoning process, diagnostic accuracy and time-on-task. In a randomized controlled trial, we analyzed the clinical reasoning process of 46 medical students with six VPs in three different variations: (1) patients showing a friendly behavior, (2) patients showing a disruptive behavior and (3) a version without a patient story. For easy VPs, we did not see a significant difference in diagnostic accuracy. For difficult VPs, the diagnostic accuracy was significantly higher for participants who worked on the friendly VPs compared to the other two groups. Independent from VP difficulty, participants identified significantly more problems and tests for disruptive than for friendly VPs; time on task was comparable for these two groups. The extrinsic motivation of participants working on the VPs without a patient story was significantly lower than for the students working on the friendly VPs. Our results indicate that the measured VP difficulty has a higher influence on the clinical reasoning process and diagnostic accuracy than the variations in the narratives.

Evidence for supplemental treatments in androgenetic alopecia.

Science.gov (United States)

Famenini, Shannon; Goh, Carolyn

2014-07-01

Currently, topical minoxidil and finasteride are the only treatments that have been FDA approved for the treatment of female pattern hair loss and androgenetic alopecia. Given the incomplete efficacy and sife effect profile of these medications, some patients utilize alternative treatments to help improve this condition. In this review, we illustrate the scientific evidence underlying the efficacy of these alternative approaches, including biotin, caffeine, melatonin, a marine extract, and zinc.

Intestinal Dysbiosis and Biotin Deprivation Induce Alopecia through Overgrowth of Lactobacillus murinus in Mice.

Science.gov (United States)

Hayashi, Atsushi; Mikami, Yohei; Miyamoto, Kentaro; Kamada, Nobuhiko; Sato, Toshiro; Mizuno, Shinta; Naganuma, Makoto; Teratani, Toshiaki; Aoki, Ryo; Fukuda, Shinji; Suda, Wataru; Hattori, Masahira; Amagai, Masayuki; Ohyama, Manabu; Kanai, Takanori

2017-08-15

Metabolism by the gut microbiota affects host physiology beyond the gastrointestinal tract. Here, we find that antibiotic-induced dysbiosis, in particular, overgrowth of Lactobacillus murinus (L. murinus), impaired gut metabolic function and led to the development of alopecia. While deprivation of dietary biotin per se did not affect skin physiology, its simultaneous treatment with vancomycin resulted in hair loss in specific pathogen-free (SPF) mice. Vancomycin treatment induced the accumulation of L. murinus in the gut, which consumes residual biotin and depletes available biotin in the gut. Consistently, L. murinus induced alopecia when monocolonized in germ-free mice fed a biotin-deficient diet. Supplementation of biotin can reverse established alopecia symptoms in the SPF condition, indicating that L. murinus plays a central role in the induction of hair loss via a biotin-dependent manner. Collectively, our results indicate that luminal metabolic alterations associated with gut dysbiosis and dietary modifications can compromise skin physiology. Copyright © 2017. Published by Elsevier Inc.

TREATMENT SUCCESS IN THREE ANDEAN BEARS (TREMARCTOS ORNATUS) WITH ALOPECIA SYNDROME USING OCLACITINIB MALEATE (APOQUEL®).

Science.gov (United States)

Drake, Gabby J; Nuttall, Tim; López, Javier; Magnone, William; Leclerc, Antoine; Potier, Romain; Lécu, Alexis; Guézénec, Maëlle; Kolter, Lydia; Nicolau, Amélie; Lemberger, Karin; Pin, Didier; Cosgrove, Sallie B

2017-09-01

Andean bear (Tremarctos ornatus) alopecia syndrome (ABAS) commonly affects captive bears, particularly sexually mature females. ABAS is characterized by bilaterally symmetrical predominantly flank alopecia with or without profound pruritus and secondary bacterial and Malassezia infections. There is no effective treatment and severely affected bears have been euthanized. This paper describes the successful management of ABAS in three female Andean bears. Skin biopsies and cytology revealed a mixed dermal inflammatory infiltrate, alopecia, hyperkeratosis, and Malassezia dermatitis. Allergen specific serology was positive for environmental allergens in one case. Hematology, serum biochemistry, and thyroid and adrenal function were normal in all cases. There was no consistent response to novel diet trials, antifungals, antihistamines, allergen specific immunotherapy, or topical antimicrobials. There was a partial response to ciclosporin (Atopica® cat, Novartis Animal Health; 5 mg/kg po, sid) in one case and oral glucocorticoids in all cases (dexamethasone sodium phosphate, [Colvasone 0.2%, Norbrook], 0.15 mg/kg po, sid or prednisolone [Deltacortene, Bruno Farmaceutici, and Megasolone 20, Coophavet], 0.3-1.2 mg/kg po, sid), but treatment was withdrawn following adverse effects. Treatment with oclacitinib maleate (Apoquel®, Zoetis; 0.46-0.5 mg/kg po, bid) resulted in rapid and complete resolution of the pruritus with subsequent improvement in demeanor and fur regrowth. After 5 mo, the bears were almost fully furred and off all other medication. Treatment was tapered to the lowest dose that prevented relapse of the pruritus (0.23-0.4 mg/kg po, sid). No adverse effects have been noted. ABAS is usually an intractable condition, and, to our knowledge, oclacitinib is the first treatment shown to result in sustained clinical improvement. Further studies on the etiology of ABAS, and on efficacy and long-term safety of oclacitinib are needed.

Personal Narratives: Cultural Differences and Clinical Implications

Science.gov (United States)

Bliss, Lynn S.; McCabe, Allyssa

2008-01-01

A study was conducted to examine the misdiagnosis of cultural difference deficits and how mistaking deficits in narrative production for cultural differences can be avoided. Findings reveal the implications for intervention.

The Effect of Neodymium: Yttrium Aluminum Garnet and Fractional Carbon Dioxide Lasers on Alopecia Areata: A Prospective Controlled Clinical Trial.

Science.gov (United States)

Yalici-Armagan, Basak; Elcin, Gonca

2016-04-01

Effective treatment options for alopecia areata (AA) are missing. Whether lasers might be effective is a topic of debate. We aimed to evaluate whether neodymium: yttrium aluminum garnet (Nd:YAG) or fractional carbon dioxide lasers might stimulate the development of new hair. Thirty-two patients who had long-standing and treatment refractory diseases were recruited for the study. Three different patches on the scalp were selected, 1 of which served as control. The mean outcome measure was the hair count, which was calculated with the digital phototrichogram. Response was defined as at least 25% increase in the mean hair count at the treated patch compared with the control patch. At the end of the study, there was no statistically significant difference in the mean hair count for the 3 patches. In 7 of 32 patients (22%), an increase in the mean hair count was observed on the whole scalp including the control patch, which resulted in an improved Severity of Alopecia Tool (SALT) score. We have observed that Nd:YAG or fractional carbon dioxide lasers did not increase the mean hair count on the treated AA patches when compared with the control patch. However, an SALT score improvement in 22% of the patients suggested spontaneous remission.

Estradiol-induced alopecia in five dogs after contact with a transdermal gel used for the treatment of postmenopausal symptoms in women.

Science.gov (United States)

Wiener, Dominique J; Rüfenacht, Silvia; Koch, Hans J; Mauldin, Elizabeth A; Mayer, Ursula; Welle, Monika M

2015-10-01

Noninflammatory alopecia is a frequent problem in dogs. Estrogen-induced alopecia is well described in dogs, with estrogen producing testicular tumors and canine female hyperestrogenism. To increase awareness that extensive alopecia in dogs can be caused by exposure to estradiol gel used by owners to treat their postmenopausal symptoms. Skin biopsies from five dogs with extensive alopecia were examined. Owners were asked for a thorough case history, including possible exposure to an estradiol gel. Complete blood work and serum chemistry panel analysis were performed to investigate possible underlying causes. Formalin-fixed skin biopsy samples were obtained from lesional skin and histopathology was performed. All owners confirmed the use of a transdermal estradiol gel and close contact with the affected dogs before development of alopecia. Histopathologic examination showed a similar picture in all five dogs. Most hair follicles were predominantly either in kenogen or telogen and hair follicle infundibula showed mild to moderate dilation. Hair regrowth was present in all five dogs after the exposure to the estradiol gel was stopped or minimized. Blood work and serum chemistry panel were within normal limits in all cases. One dog had elevated estradiol concentrations, whereas in another dog estradiol concentrations were within normal limits. Alopecia can occur after contact with a transdermal gel used as treatment for postmenopausal symptoms in women. Estradiol gel used by female owners therefore represents a possible cause for noninflammatory alopecia in dogs. Estradiol concentrations are not necessarily elevated in affected dogs. © 2015 ESVD and ACVD.

Alopecia areata: Treatment options

Directory of Open Access Journals (Sweden)

E. Kasumagić-Halilović

2006-02-01

Full Text Available Alopecia areata (AA is a common cause of reversible hair loss afflictingapproximately1-2%ofthegeneralpopulation. It commonly present as round patches of hair loss which can be the firstmanifestationofamoreseverealopecia totalis or universalis. The cause of AA is unknown although most evidence supports the hypothesis that AA is an immunologically mediated disease. Treatment of AA may be divided into four different categories of widely accepted therapeutic modalities: immune inhibitors (steroid or psoralen and UVA light- PUVA, topicalsensitizers (squaric acid dibutylester and diphenylcyclopropenone, non-specificirritants(anthralinandthevasodilatator minoxidil. Improved future treatments may be immunosuppressive or immunomodulatory or they may otherwise protect hair follicles from the injurious effects of inflammation.Theaimofthisarticleistoreviewavailable data on current and potential agents for the treatment of AA.

Nail changes in alopecia areata: Incidence and pattern

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Gandhi V

2003-03-01

Full Text Available One hundred consecutive patients with alopecia areata were examined for presence of nail abnormalities. Nail changes were seen in 44/100 (44% of patients with most frequent occurrence in multifocal variety (30/44=68%. The commonest abnormality observed was superficial pits seen in 28(64% patients. Presence and severity of nail changes may indicate a more severe and recalcitrant disease.

Exomic sequencing of immune-related genes reveals novel candidate variants associated with alopecia universalis.

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Seungbok Lee

Full Text Available Alopecia areata (AA is a common autoimmune disorder mostly presented as round patches of hair loss and subclassified into alopecia totalis/alopecia universalis (AT/AU based on the area of alopecia. Although AA is relatively common, only 5% of AA patients progress to AT/AU, which affect the whole scalp and whole body respectively. To determine genetic determinants of this orphan disease, we undertook whole-exome sequencing of 6 samples from AU patients, and 26 variants in immune-related genes were selected as candidates. When an additional 14 AU samples were genotyped for these candidates, 6 of them remained at the level of significance in comparison with 155 Asian controls (p<1.92×10(-3. Linkage disequilibrium was observed between some of the most significant SNPs, including rs41559420 of HLA-DRB5 (p<0.001, OR 44.57 and rs28362679 of BTNL2 (p<0.001, OR 30.21. While BTNL2 was reported as a general susceptibility gene of AA previously, HLA-DRB5 has not been implicated in AA. In addition, we found several genetic variants in novel genes (HLA-DMB, TLR1, and PMS2 and discovered an additional locus on HLA-A, a known susceptibility gene of AA. This study provides further evidence for the association of previously reported genes with AA and novel findings such as HLA-DRB5, which might represent a hidden culprit gene for AU.

CRF receptor antagonist astressin-B reverses and prevents alopecia in CRF over-expressing mice.

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Lixin Wang

2011-02-01

Full Text Available Corticotropin-releasing factor (CRF signaling pathways are involved in the stress response, and there is growing evidence supporting hair growth inhibition of murine hair follicle in vivo upon stress exposure. We investigated whether the blockade of CRF receptors influences the development of hair loss in CRF over-expressing (OE-mice that display phenotypes of Cushing's syndrome and chronic stress, including alopecia. The non-selective CRF receptors antagonist, astressin-B (5 µg/mouse injected peripherally once a day for 5 days in 4-9 months old CRF-OE alopecic mice induced pigmentation and hair re-growth that was largely retained for over 4 months. In young CRF-OE mice, astressin-B prevented the development of alopecia that occurred in saline-treated mice. Histological examination indicated that alopecic CRF-OE mice had hair follicle atrophy and that astressin-B revived the hair follicle from the telogen to anagen phase. However, astressin-B did not show any effect on the elevated plasma corticosterone levels and the increased weights of adrenal glands and visceral fat in CRF-OE mice. The selective CRF₂ receptor antagonist, astressin₂-B had moderate effect on pigmentation, but not on hair re-growth. The commercial drug for alopecia, minoxidil only showed partial effect on hair re-growth. These data support the existence of a key molecular switching mechanism triggered by blocking peripheral CRF receptors with an antagonist to reset hair growth in a mouse model of alopecia associated with chronic stress.

Narratives of neoliberalism: 'clinical labour' in context.

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Parry, Bronwyn

2015-06-01

Cross-border reproductive care has been thrust under the international spotlight by a series of recent scandals. These have prompted calls to develop more robust means of assessing the exploitative potential of such practices and the need for overarching and normative forms of national and international regulation. Allied theorisations of the emergence of forms of clinical labour have cast the outsourcing of reproductive services such as gamete donation and gestational surrogacy as artefacts of a wider neoliberalisation of service provision. These accounts share with many other narratives of neoliberalism a number of key assertions that relate to the presumed organisation of labour relations within this paradigm. This article critically engages with four assumptions implicit in these accounts: that clinical labourers constitute a largely homogeneous underclass of workers; that reproductive labour has been contractualised in ways that disembed it from wider social and communal relations; that contractualisation can provide protection for clinical labour lessening the need for formal regulatory oversight; and that the transnationalisation of reproductive service labour is largely unidirectional and characterised by a dynamic of provision in which 'the rest' services 'the West'. Drawing on the first findings of a large-scale ethnographic research project into assisted reproduction in India I provide evidence to refute these assertions. In so doing the article demonstrates that while the outsourcing and contractualisation of reproductive labour may be embedded in a wider neoliberal paradigm these practices cannot be understood nor their impacts be fully assessed in isolation from their social and cultural contexts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[Psychic factors in case histories of patients with alopecia areata--preliminary report].

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Wygledowska-Kania, M; Bogdanowski, T

1996-01-01

We tested the significance of psychic factors in the etiopathogenesis of alopecia areata. We analysed the patient on the basis of a detailed examination based on the case history, including important events in his/her life, personality traits, serious events and the loss of emotional attachment. General important events happened to 80% of the patients, personality traits able to cause the disease were present in 73%, serious events in 62% and the loss of emotional attachment was also found in 62% of the patients. We tested 60 patients (31 women and 29 men). The evidence obtained from the detailed examination based on case histories indicated significantly frequent occurrence of the psychic factors preceding the occurrence of alopecia areata.

Diphenylcyclopropenone in patients with alopecia areata. A critically appraised topic

NARCIS (Netherlands)

Kuin, R. A.; Spuls, P. I.; Limpens, J.; van Zuuren, E. J.

2015-01-01

To assess the efficacy and safety of topical diphenylcyclopropenone (DPCP) in patients with alopecia areata. Study selection, data extraction, risk of bias assessment and analyses were carried out independently by two authors. The quality of evidence was rated with Grading of Recommendations

Combined treatment with oral finasteride and topical minoxidil in male androgenetic alopecia: a randomized and comparative study in Chinese patients.

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Hu, Ruiming; Xu, Feng; Sheng, Youyu; Qi, Sisi; Han, Yumei; Miao, Ying; Rui, Wenlong; Yang, Qinping

2015-01-01

Finasteride at 1 mg/day and 5% topical minoxidil are effective in male androgenetic alopecia (MAGA). However, studies describing their effects in Chinese individuals are scarce. 450 Chinese MAGA patients were randomly assigned to receive finasteride (n = 160), minoxidil (n = 130) and combined medication (n = 160) for 12 months. The patients returned to the clinic every 3 months for efficacy evaluation. And efficacy was evaluated in 428 men at treatment end, including 154, 122, and 152 in the finasteride, 5% minoxidil, and combination groups, respectively. All groups showed similar baseline characteristics, including age at enrollment, and duration and severity of alopecia (p > 0.05). At 12 months, 80.5, 59, and 94.1% men treated with finasteride, 5% minoxidil and the combination therapy showed improvement, respectively. Adverse reactions were rare (finasteride, 1.8%; minoxidil, 6.1%), and disappeared right after drug withdrawal. In conclusion, finasteride is superior to 5% minoxidil, while the combined medication showed the best efficacy. © 2015 Wiley Periodicals, Inc.

Det narrative og narrative undervisningsformer

DEFF Research Database (Denmark)

2010-01-01

I denne power point gennem grundtrækkene i den narrative vending og der kommes med eksempler på narrative undervisningsformer.......I denne power point gennem grundtrækkene i den narrative vending og der kommes med eksempler på narrative undervisningsformer....

'My wig has been my journey's companion': perceived effects of an aesthetic care programme for Italian women suffering from chemotherapy-induced alopecia.

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Zannini, L; Verderame, F; Cucchiara, G; Zinna, B; Alba, A; Ferrara, M

2012-09-01

This study explored the perceived effects of an aesthetic care/wig programme for Italian women suffering from chemotherapy-induced alopecia. Despite advances in the treatment of many side effects of chemotherapy, alopecia remains difficult to resolve. Literature suggests that patients' reactions to alopecia and camouflaging strategies depend on their gender, individual characteristics, social context, and culture. A qualitative study was designed involving 20 patients from Sicily (Italy), who participated in an aesthetic care programme. Data were collected through semi-structured interviews, and an Interpretative Phenomenological Analysis was conducted on transcriptions. Our findings showed that, even if expected, alopecia is experienced as a traumatic event that challenges a woman's femininity, as reported by many other enquiries. Diverging from other studies, the wig is perceived as very helpful, since it camouflages baldness and reduces the 'sick aspect' related to alopecia. Patients consider their wig to be a 'friend', and it appears that through the aesthetic care programme they received support they otherwise would not have sought. We conclude that aesthetic care/wig programmes can help women affected by alopecia to cope with cancer 'stigma', especially in those rural contexts where psychosocial programmes are not frequently embraced by patients due to environmental and cultural barriers. © 2012 Blackwell Publishing Ltd.

Use of body and beard donor hair in surgical treatment of androgenic alopecia

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Arvind Poswal

2013-01-01

Full Text Available Objectives: Follicular unit transplant is a widely used surgical treatment for androgenic alopecia. However, for patients with extensive hair loss (Norwood 5 and above, scalp donor hair are not sufficient to cover all areas of baldness. This study aims to assess suitability of beard and body donor hair when transplanted to the scalp. Materials and Methods: In 35 male patients having varying degrees of androgenic alopecia, body and beard donor hair were extracted by follicular unit extraction method (under local anesthesia. They were transplanted in different locations of the scalp. Follow-up was carried out at various intervals (6 months to 2 years. The hairs were observed for colour, curl and calibre. Results: In all the patients, there was no change in the colour, curl or calibre of the transplanted body/beard hair. They maintained the same characteristics as in their original location. Conclusion: Body and beard hair can be used as additional donor resource for treating androgenic alopecia. These hairs, however, do not change their colour, curl, and shaft diameter (calibre. Thus, proper planning is a must when using the different types of donor hair for transplanting.

Stuck in the past: negative bias, explanatory style, temporal order, and evaluative perspectives in life narratives of clinically depressed individuals.

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Habermas, Tilmann; Ott, Lisa-M; Schubert, Merve; Schneider, Beatrix; Pate, Anna

2008-01-01

This study attempted to replicate negative bias and depressive explanatory style in depression using life narratives. The two central aspects of narrative, temporal succession and evaluation, were also explored. These aspects were tested for the first time using entire life narratives of 17 depressed inpatients and non-depressed controls matched for sex and educational level. Negative bias and depressive explanatory style were replicated as typical for the depressed group. Life narratives of depressed patients also deviated more from a linear temporal order and compared less frequently the past with the present. Contrary to expectations, the depressed did not differ in the overall frequency of evaluations. However, they used more past than present evaluations and more experience-near evaluations than cognitive evaluations, suggesting that they are more immersed in past experiences. It is concluded that negative bias and depressive explanatory style can be found also in a naturalistic narrative measure, and that depression affects the two major aspects of narrative. It is argued that life narratives, as measures close to everyday clinical practice and as the most encompassing form of self-representation, should complement more experimental procedures in the study of cognitive and communicative processes in psychopathology. 2007 Wiley-Liss, Inc.

Characteristics of leadership that influence clinical learning: a narrative review.

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Walker, Rachel; Cooke, Marie; Henderson, Amanda; Creedy, Debra K

2011-11-01

Leadership has been consistently implied in fostering clinical learning. However there is a lack of clarity about the form leadership should take. Limited quantitative research indicated a narrative approach to review literature from a broad perspective. A framework to guide the synthesis was developed to ensure a rigorous review process. Preliminary reading and review of papers using search terms nursing and leadership and clinical learning and learning culture narrowed the inclusion criteria to 245 papers published between 2000 and 2010. Given the diversity of the papers' focus, aim and context, a refined screening process justified the inclusion of twenty-six papers in the review. A critical appraisal of these peer-reviewed quantitative, qualitative and commentary papers identified factors/elements integral to effective leadership. Across the literature leadership was discussed in relation to two broad themes: influence of leadership on organisational learning and development and; influence of leadership on undergraduate clinical education. The factors central to leadership emerged as transformative principles, the role of the nurse unit/ward manager, collaboration and relationship building and role-modelling. The review has raised some suggestions for future research aimed at examining the impact of a leadership capacity building intervention that supports clinical learning. Copyright © 2010 Elsevier Ltd. All rights reserved.

Methotrexate in Alopecia Areata: A Report of Three Cases

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Batalla, Ana; Fl?rez, ?ngeles; Abalde, Teresa; V?zquez-Veiga, Hugo

2016-01-01

There are few studies about systemic treatment in severe cases of alopecia areata (AA), especially in the pediatric population. Although there is more experience with systemic corticosteroids, recent reports have suggested methotrexate (MTX) as an alternative treatment, with a relatively good outcome. We describe three cases of AA in children treated with MTX, two of them with successful results.

Androgenetic Alopecia: A Chronic or Pubertal Onset Disease Retarded by Blood Donation

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Mohammad Reza Dayer

2017-09-01

Full Text Available Background Androgenetic alopecia is the main cause of hair loss and common baldness that affects psychological more than physiological aspects of people’s lives. Studies have shown that this multi factorial disorder is initiated by androgens secretion in pubertal period, minerals limitations, autoimmunity, mental stress, genetic predisposition and some alterations in hematological factors. Objectives The aim of this study was to evaluate the involvement of hematologic parameters in this disease using a case control study design. Methods In this case-controlled study, two groups each of 80 individuals with androgenetic alopecia were voluntarily included in the study based on their medical histories and clinical examinations and subjected to blood tests for routine hematological parameters. The results were then compared and analyzed using SPSS version 16.0. Results Our findings indicated that all the parameters for both groups fall in normal ranges (Mean ± SD but the values for RBC, HGB, MCH, MCHC, WBC, LYM and TIBC were significantly higher in patients than in normal group. The average counts of PLT was significantly lower in patients compared with the normal group. Otherwise, Person’s tests for statistical correlations between two groups indicated that the pattern of correlations were abnormal in patients. Conclusions Our findings indicated the presence of a chronic, immunologic and slowly progressing disorder that causes hair loss, the disease which is in turn triggered in pubertal period upon androgen secretion. We suggest, therefore, that the conditions may be ameliorated by prescription of iron tablet, platelet transfusion and anti-inflammation therapy.

A bibliometric study of scientific literature in Scopus on botanicals for treatment of androgenetic alopecia.

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Rondanelli, Mariangela; Perna, Simone; Peroni, Gabriella; Guido, Davide

2016-06-01

In androgenetic alopecia, a number of botanicals are available that can effectively slow or reduce hair loss and inflammation or stimulate partial hair regrowth. The aim of this study was to provide a descriptive overview of the impact and production of literature on botanicals used for androgenetic alopecia and to perform a citation analysis of the related research articles. We searched for "alopecia" OR "androgenetic alopecia" OR "hair loss" AND "Camelia sinensis" OR (and other 15 botanicals) in ARTICLE (Title/Abstract/Keyword) in Scopus database. A total of 29 references, that is, research articles, were retrieved by SCOPUS search, and 93.1% had been published since 2000. The majority (48.3%) describe applications of hair grow stimulants, followed by inhibitors of 5-alpha-reductase applications (27.6%), and studies concerning inhibitors of inflammation (24.1%). The citation analysis revealed a growing interest for this topic and the papers on hair grow stimulants are most cited. Citation trend of inhibition of 5-alpha-reductase articles is growing in the last years. This study has highlighted three important aspects: (1) growing interest for this topic; (2) evidences mainly in hair grow stimulants and recently in the inhibition of 5-alpha-reductase, as demonstrated by article and citation counts across years; (3) in addition, all major studies have been focused on green tea epigallocatechin-3-gallate, Serenoa repens, Citrullus colocynthis and Cuscuta reflexa. © 2015 Wiley Periodicals, Inc.

Narratives of neoliberalism: ‘clinical labour’ in context

Science.gov (United States)

Parry, Bronwyn

2015-01-01

Cross-border reproductive care has been thrust under the international spotlight by a series of recent scandals. These have prompted calls to develop more robust means of assessing the exploitative potential of such practices and the need for overarching and normative forms of national and international regulation. Allied theorisations of the emergence of forms of clinical labour have cast the outsourcing of reproductive services such as gamete donation and gestational surrogacy as artefacts of a wider neoliberalisation of service provision. These accounts share with many other narratives of neoliberalism a number of key assertions that relate to the presumed organisation of labour relations within this paradigm. This article critically engages with four assumptions implicit in these accounts: that clinical labourers constitute a largely homogeneous underclass of workers; that reproductive labour has been contractualised in ways that disembed it from wider social and communal relations; that contractualisation can provide protection for clinical labour lessening the need for formal regulatory oversight; and that the transnationalisation of reproductive service labour is largely unidirectional and characterised by a dynamic of provision in which ‘the rest’ services ‘the West’. Drawing on the first findings of a large-scale ethnographic research project into assisted reproduction in India I provide evidence to refute these assertions. In so doing the article demonstrates that while the outsourcing and contractualisation of reproductive labour may be embedded in a wider neoliberal paradigm these practices cannot be understood nor their impacts be fully assessed in isolation from their social and cultural contexts. PMID:26052118

Efficacy of low-level laser therapy on hair regrowth in dogs with noninflammatory alopecia: a pilot study.

Science.gov (United States)

Olivieri, Lara; Cavina, Damiano; Radicchi, Giada; Miragliotta, Vincenzo; Abramo, Francesca

2015-02-01

Canine noninflammatory alopecia (CNA) is a heterogeneous group of skin diseases with different underlying pathogenesis. The therapeutic approach is challenging, and new options for treatment are desirable. To test the clinical efficacy of low-level laser therapy (LLLT) on hair regrowth in CNA. Seven dogs of different ages, breeds and genders with a clinical and histopathological diagnosis of noninflammatory alopecia. Each dog was treated twice weekly for a maximum of 2 months with a therapeutic laser producing the following three different wavelengths emerging simultaneously from 21 foci: 13 × 16 mW, 470 nm; 4 × 50 mW, 685 nm; and 4 × 200 mW, 830 nm. The fluence given was 3 J/cm(2) , frequency 5 Hz, amplitude of the irradiated area was 25 cm(2) and application time was 1.34 min. A predetermined alopecic area was left untreated and served as a control area. From one dog, post-treatment biopsies of treated and untreated sites were obtained for histological evaluation of hair density and the percentage of haired and nonhaired follicles. At the end of the study, coat regrowth was greatly improved in six of seven animals and improved in one of seven. By morphometry, the area occupied by hair follicles was 18% in the treated sample and 11% in the untreated one (11%); haired follicles were (per area) 93% in the treated sample and only 9% in the control sample. Our clinical and histological data document promising effects of LLLT on hair regrowth in CNA. Further studies investigating the biological mechanism underlying the effect of LLLT on hair follicle cycling are warranted. © 2014 ESVD and ACVD.

Psychiatric morbidity and quality of life in skin diseases: A comparison of alopecia areata and psoriasis

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Sagar B Karia

2015-01-01

Full Text Available Background: Alopecia areata (AA and psoriasis are associated with various psychiatric comorbidities. Both greatly affect the quality of life (QOL of patients and psychiatric comorbidities can further worsen it. Thus there is need to recognise psychiatric comorbidities and treat them in these patients. Aims: To determine the psychiatric morbidity and the QOL in these patients to study the factors affecting them. Methodology: 50 patients each of psoriasis and AA were included. 50 people accompanying these patients served as control group. They were diagnosed for psychiatric disorders by clinical interview. Scales used were severity of alopecia tool for AA, psoriasis area and severity index for psoriasis, WHO-QOL scale, Hamilton Rating Scale for anxiety and depression. Results: 22% and 38% patients in AA and psoriasis group respectively suffered from psychiatric disorder, depression was present in 18% and 24% of patients and 4% and 12% had anxiety disorders in respective groups. The control group had only 6% of psychiatric comorbidities. QOL scores had negative correlation with Hamilton-A, Hamilton-D and severity of psoriasis scores and they were statistically significant but not with severity of AA. Conclusion: Thus AA and psoriasis patients had more prevalence of psychiatric comorbidities and it had bearing on their QOL.

Mutilating keratoderma with concomitant alopecia and keratoses follicularis spinulosa decalvans: X-linked olmsted syndrome and its response to isotretinoin

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Gunjan Verma

2017-01-01

Full Text Available We report a case of mutilating keratoderma with alopecia and keratoses follicularis spinulosa decalvans (KFSD, which was initially diagnosed as ectodermal dysplasia and Olmsted syndrome but was revisited as a case of X-linked Olmsted (XLO syndrome. We focus on this uncommon entity (XLO to highlight the differentials of alopecia with palmoplantar keratoderma.

Emotions, narratives, and ethical mindfulness.

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Guillemin, Marilys; Gillam, Lynn

2015-06-01

Clinical care is laden with emotions, from the perspectives of both clinicians and patients. It is important that emotions are addressed in health professions curricula to ensure that clinicians are humane healers as well as technical experts. Emotions have a valuable and generative role in health professional ethics education.The authors have previously described a narrative ethics pedagogy, the aim of which is to develop ethical mindfulness. Ethical mindfulness is a state of being that acknowledges everyday ethics and ethically important moments as significant in clinical care, with the aim of enabling ethical clinical practice. Using a sample narrative, the authors extend this concept to examine five features of ethical mindfulness as they relate to emotions: (1) being sensitized to emotions in everyday practice, (2) acknowledging and understanding the ways in which emotions are significant in practice, (3) being able to articulate the emotions at play during ethically important moments, (4) being reflexive and acknowledging both the generative aspects and the limitations of emotions, and (5) being courageous.The process of writing and engaging with narratives can lead to ethical mindfulness, including the capacity to understand and work with emotions. Strategies for productively incorporating emotions in narrative ethics teaching are described. This can be a challenging domain within medical education for both educators and health care students and thus needs to be addressed sensitively and responsibly. The potential benefit of educating health professionals in a way which addresses emotionality in an ethical framework makes the challenges worthwhile.

The role of narrative medicine in pregnancy after liver transplantation.

Science.gov (United States)

Donzelli, Gianpaolo; Paddeu, Erika Maria; D'Alessandro, Francesca; Nanni Costa, Alessandro

2015-01-01

Narrative medicine allows professionals from all fields of medical sciences to understand the patient's total experience of illness, and meet his/her needs in an empathetic environment. Narrative medicine helps spread holistic knowledge of a multitude of complex clinical conditions, including transplantation. To underline the role of narrative medicine in women who become pregnant after a liver transplant by using their narrations of this very special experience. We describe our study with narration and listening to the stories of three women expecting their first child after a liver transplant, by analysing the structure and role of narration in the context of relationships between patients and caregivers. The narrations were transcribed verbatim with the main plot analysed in order to address all the aspects of this rare clinical condition and the transition to parenthood. The women narrated this experience in three phases: transplantation, pregnancy and delivery, and post-partum. They described all phases of pregnancy as stressful but satisfying, whereas the fact of becoming a mother was perceived as a victory both as a woman and as a transplant patient. Our results suggest that narrative medicine represents a significant professional tool for caring for transplant patients during pregnancy.

Efficacy of non-surgical treatments for androgenetic alopecia: a systematic review and network meta-analysis.

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Gupta, Aditya K; Mays, Rachel R; Dotzert, Michelle S; Versteeg, Sarah G; Shear, Neil H; Piguet, Vincent

2018-05-24

Androgenetic alopecia, or male/female pattern baldness, is the most common type of progressive hair loss disorder. The aim of this paper is to review recent advances in non-surgical treatments for androgenetic alopecia and identify the most effective treatments. A network meta-analysis (NMA) was conducted of the available literature of the six most common non-surgical treatment options for treating androgenetic alopecia in both men and women; dutasteride 0.5mg, finasteride 1mg, low level laser therapy (LLLT), minoxidil 2%, minoxidil 5% and platelet rich plasma (PRP). Seventy-eight studies met the inclusion criteria and twenty-two studies had the data necessary for a network meta-analysis. Relative effects show LLLT as the superior treatment. Relative effects show PRP, finasteride 1 mg (male), finasteride 1 mg (female), minoxidil 5%, minoxidil 2% and dutasteride (male) are approximately equivalent in mean change hair count following treatment. Minoxidil 5% and minoxidil 2% reported the most drug-related adverse events (n=45 and n=23, respectively). The quality of evidence of minoxidil 2% vs. minoxidil 5% was high; minoxidil 5% vs. placebo was moderate; dutasteride (male) vs. placebo, finasteride (female) vs placebo, minoxidil 2% vs. placebo, minoxidil 5% vs. LLLT was low and finasteride (male) vs. placebo, LLLT vs. sham, PRP vs. placebo, finasteride vs. minoxidil 2% was very low. Results of this NMA indicate the emergence of novel, non-hormonal therapies as effective treatments for hair loss; however, the quality of evidence is generally low. High quality randomized controlled trials and head to head trials are required to support these findings and aid in the development of more standardized protocols, particularly for PRP. Regardless, this analysis may aid physicians in clinical decision making and highlight the variety of non-surgical hair restoration options for patients. This article is protected by copyright. All rights reserved. This article is protected by

Excimer laser: a module of the alopecia areata common protocol.

Science.gov (United States)

McMichael, Amy J

2013-12-01

Alopecia areata (AA) is an autoimmune condition characterized by T cell-mediated attack of the hair follicle. The inciting antigenic stimulus is unknown. A dense perbulbar lymphocytic infiltrate and reproducible immunologic abnormalities are hallmark features of the condition. The cellular infiltrate primarily consists of activated T lymphocytes and antigen-presenting Langerhans cells. The xenon chloride excimer laser emits its total energy at the wavelength of 308 nm and therefore is regarded as a "super-narrowband" UVB light source. Excimer laser treatment is highly effective in psoriasis, another T cell-mediated disorder that shares many immunologic features with AA. The excimer laser is superior in inducing T cell apoptosis in vitro compared with narrowband UVB, with paralleled improved clinical efficacy. The excimer laser has been used successfully in patients with AA. In this context, evaluation of the potential benefit of 308-nm excimer laser therapy in the treatment of AA is clinically warranted. Herein, the use of a common treatment protocol with a specifically designed module to study the outcome of excimer laser treatment on moderate-to-severe scalp AA in adults is described.

Vitiligo and alopecia areata associated with subclinical/clinical hypothyroidism.

Science.gov (United States)

Sehgal, Virendra N

2011-01-01

/dL (86-186); total thyroxine (T4), 6.54 microg/dL (4.5-12.5 microg/dL); and thyroid-stimulating hormone (TSH), 0.32 microIU/mL (0.3-5.6 microIU/mL), supplemented by antithyroid microsomal peroxidase antibodies (thyroid microsomal antibody and thyroid peroxidase), 21.9 IU/mL (1-40 IU/mL), and antithyroglobulin antibodies, 78.1 U/mL (1-100 U/mL). During the patient's treatment period, 4 other patients with clinical symptoms and signs of long-standing hypothyroidism developed vitiligo, the duration of which was variable in each patient (Table I). All of the patients were taking thyroxin. Thyroid and lipid profiles were performed periodically to evaluate the progress (Table I). These patients were also treated with PUVA therapy and thyroxin. During the course of treatment, 2 of the patients noticed asymptomatic, progressive, localized, and well-circumscribed hair loss at the temporal region of the scalp that extended to involve the vertex, conforming to findings of alopecia areata (Figure 2A and Figure 2B).

[Excimer laser therapy of alopecia areata--side-by-side evaluation of a representative area].

Science.gov (United States)

Raulin, Christian; Gündogan, Cüneyt; Greve, Bärbel; Gebert, Susanne

2005-07-01

We report for the first time on hair regrowth in alopecia areata of the scalp achieved with the 308-nm xenon-chloride excimer laser in a prospective side-by-side trial. The alopecia areata had shown progression over a period of three years, and various treatments had not been effective. Out of a number of affected areas, one representative lesion was chosen; one half of it was treated, the other half remained untreated. After 27 sessions (200 - 4000 mJ/cm2, cumulative dose 52.6 J/cm2) over 3 months, only the treated area showed hair growth; which suggests that this was most probably not a spontaneous remission.

Hemorrhagic Ischemic Retinal Vasculitis and Alopecia Areata as a Manifestation of HLA-B27.

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Sharma, Ravi; Randhawa, Sandeep

2018-01-01

A 12-year-old Indian boy presented with acute and severe vision loss in his right eye. He was being treated for scalp alopecia areata and rashes behind the ears and above the brow. The eye examination revealed unilateral hemorrhagic retinal vasculitis. The lab work was normal except for a positive HLA-B27 result. The patient was treated with intravitreal bevacizumab (Avastin; Genentech, South San Francisco, CA) and systemic immunosuppression. The retinal vasculitis improved with treatment, but visual acuity only mildly improved. The alopecia areata also improved with systemic immunosuppression. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:60-63.]. Copyright 2018, SLACK Incorporated.

Drug side effect extraction from clinical narratives of psychiatry and psychology patients.

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Sohn, Sunghwan; Kocher, Jean-Pierre A; Chute, Christopher G; Savova, Guergana K

2011-12-01

To extract physician-asserted drug side effects from electronic medical record clinical narratives. Pattern matching rules were manually developed through examining keywords and expression patterns of side effects to discover an individual side effect and causative drug relationship. A combination of machine learning (C4.5) using side effect keyword features and pattern matching rules was used to extract sentences that contain side effect and causative drug pairs, enabling the system to discover most side effect occurrences. Our system was implemented as a module within the clinical Text Analysis and Knowledge Extraction System. The system was tested in the domain of psychiatry and psychology. The rule-based system extracting side effects and causative drugs produced an F score of 0.80 (0.55 excluding allergy section). The hybrid system identifying side effect sentences had an F score of 0.75 (0.56 excluding allergy section) but covered more side effect and causative drug pairs than individual side effect extraction. The rule-based system was able to identify most side effects expressed by clear indication words. More sophisticated semantic processing is required to handle complex side effect descriptions in the narrative. We demonstrated that our system can be trained to identify sentences with complex side effect descriptions that can be submitted to a human expert for further abstraction. Our system was able to extract most physician-asserted drug side effects. It can be used in either an automated mode for side effect extraction or semi-automated mode to identify side effect sentences that can significantly simplify abstraction by a human expert.

The Use of the Clinical Ethnographic Narrative Interview to Understand and Support Help Seeking After Gender-Based Violence.

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Saint Arnault, Denise M

2017-09-01

Gender-based violence (GBV), characterized by the abduction or rape of women and girls to humiliate, intimidate, and traumatize them and their communities, is a profoundly disturbing tactic in international conflict. Long after armed conflict has ended, survivors continue to experience physical injuries, psychological trauma, and social and cultural stigma. Guilt, shame, and continued interpersonal violence can become a normalized part of daily life, significantly challenging the road to healing and recovery. Research about self-disclosure and narrative after GBV has shown that help seeking rates are shockingly low, with estimates ranging from 4-27%. From a feminist and a humanistic perspective, studying trauma history and related help seeking is delicate work that must use interview processes that ensure the survivor can tell her story without revictimization, while also aiming to restore personal mastery, empowerment, and self-understanding. Based on theories about benefits and challenges of the narrative after GBV and trauma, we propose that the Clinical Ethnographic Narrative Interview (CENI) allows researchers and practitioners a safe container to examine the complex interplay between suffering, culture, and help seeking. Using this interview, the interviewer and the participant work as partners to define, compare, and contrast the socio-cultural barriers and facilitators of help seeking. This paper explains the narrative theory and the challenges and benefits of the narrative approach after trauma. Then we provide support for the use of the CENI for an understanding of the help seeking process and facilitating a health-promoting narrative interview for survivors. We then address implications for research, practice, and policy.

Expansion of the spectrum of ITGB6-related disorders to adolescent alopecia, dentogingival abnormalities and intellectual disability

OpenAIRE

Ansar, Muhammad; Jan, Abid; Santos-Cortez, Regie Lyn P; Wang, Xin; Suliman, Muhammad; Acharya, Anushree; Habib, Rabia; Abbe, Izoduwa; Ali, Ghazanfar; Lee, Kwanghyuk; Smith, Joshua D; Nickerson, Deborah A; Shendure, Jay; Bamshad, Michael J; Ahmad, Wasim

2015-01-01

Alopecia with mental retardation (APMR) is a very rare disorder. In this study, we report on a consanguineous Pakistani family (AP91) with mild-to-moderate intellectual disability, adolescent alopecia and dentogingival abnormalities. Using homozygosity mapping, linkage analysis and exome sequencing, we identified a novel rare missense variant c.898G>A (p.(Glu300Lys)) in ITGB6, which co-segregates with the phenotype within the family and is predicted to be deleterious. Structural modeling show...

308-nm excimer lamp for the treatment of alopecia areata: Clinical trial on 16 cases

Directory of Open Access Journals (Sweden)

Akiko Ohtsuki

2013-01-01

Full Text Available Background: Alopecia areata (AA is considered as a T-cell mediated autoimmune disorder. The 308-nm excimer laser is thought to be capable of inducing T-cell apoptosis in vitro, suggesting that the 308-nm excimer lamp (not laser might be effective for the treatment of AA. We examined the effectiveness of the 308-nm excimer lamp for treating AA. Materials and Methods: We treated 16 patients with single AA and multiple AA (MAA. The lesions were irradiated with a 308-nm excimer lamp at 2-week intervals. Results: Hair regrowth was observed in 14 patients. Among them, 10 patients showed more than 50% hair re-growth. Our results suggested that the 308-nm excimer lamp system is effective and safe for the treatment of single AA and MAA. Conclusion: Our results suggest that the 308-nm excimer lamp is a good therapeutic alternative without serious side effect for treating AA.

Lichen planopilaris: Demographic, clinical and histopathological characteristics and treatment outcomes of 25 cases

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Deren Özcan

2015-12-01

Full Text Available Background and Design: Lichen planopilaris (LPP is a type of cicatricial alopecia characterized by autoreactive lymphocytic destruction of the hair follicle. We aimed to evaluate the demographic, clinical and histopathological features, and treatment outcomes of patients with LPP. Materials and Methods: Medical reports of 25 patients, who have been diagnosed with LPP according to the clinical and histopathological findings between January 2006 and June 2012, were retrospectively reviewed. The transverse and vertical sections of scalp biopsy specimens were re-evaluated by a pathologist, and the findings were noted. Results: Of the 25 patients, 18 were female and 7 were male, the mean age was 49.8±12.4 years. Eighteen patients had been diagnosed with classic LPP and 7 patients with frontal fibrosing alopecia (FFA. The alopecia has begun in postmenopausal period in 5 patients with FFA. Alopecia was associated with pruritus, pain and/or burning in 19 patients. Extra-scalp involvement was observed in 11 patients. The most common clinical findings were follicular hyperkeratosis (92%, perifollicular erythema (48%, perifollicular lichenoid papules, and positive hair-pull test (44%. Dermatoscopic examination was performed in 14 patients, and most commonly, absence of follicular openings (100%, perifollicular scales (92.9% and perifollicular erythema (50% were noted. The most common diagnostic histopathological findingsmwere follicular vacuolar and lichenoid degeneration (88% and vacuolar and lichenoid interface changes (56%. Twenty-three patients who were started on treatment received topical, intramuscular and intralesional corticosteroids, topical minoxidil, oral tetracycline, cyclosporine A, and hydroxychloroquine either alone or in combination. Progression of alopecia was prevented and the symptoms and/or signs were reduced in 12 (75% of 16 patients whose follow-up data were available. Conclusion: LPP can be diagnosed accurately through a detailed

Cost-effectiveness analysis of scalp cooling to reduce chemotherapy-induced alopecia

NARCIS (Netherlands)

van den Hurk, C.J.; van den Akker-van Marle, E.M.; Breed, W.P.M.; van de Poll-Franse, L.V.; Nortier, J.; Coebergh, J.W.W.

2014-01-01

Background. Alopecia is a frequently occurring side effect of chemotherapy that often can be prevented by cooling the scalp during the infusion. This study compared effects and costs of scalp cooling with usual general oncological care, i.e. purchasing a wig or head cover. Material and methods.

Lipid nanoparticles for topical and transdermal application for alopecia treatment: development, physicochemical characterization, and in vitro release and penetration studies

DEFF Research Database (Denmark)

Gomes, M. J.; Martins, S.; Ferreira, D.

2014-01-01

with few side effects, new drug-delivery systems able to improve alopecia therapy are urgently required. With this purpose in mind, the present study aimed to develop lipid nanoparticles (nanostructured lipid carriers) with the ability to incorporate and deliver anti-alopecia active compounds (minoxidil...... less than 30% was achieved for minoxidil nanoparticles, over 28 days. Controlled release assays in physiological conditions demonstrated that nanoparticles loaded with minoxidil yielded a prolonged release, as desired. Penetration assays through pig ear skin demonstrated that nanoparticles loaded...... with minoxidil and finasteride had low levels of penetration. These results suggest that the proposed novel formulation presents several good characteristics indicating their suitability for dermal delivery of anti-alopecia active compounds....

Lipid nanoparticles for topical and transdermal application for alopecia treatment: development, physicochemical characterization, and in vitro release and penetration studies

Directory of Open Access Journals (Sweden)

Gomes MJ

2014-03-01

Full Text Available Maria João Gomes,1 Susana Martins,2,3 Domingos Ferreira,2 Marcela A Segundo,1 Salette Reis1 1REQUIMTE, Laboratory of Applied Chemistry, Department of Chemical Sciences, Faculty of Pharmacy, 2Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal; 3Department of Physics, Chemistry and Pharmacy, University of Southern Denmark, Odense, Denmark Abstract: Alopecia is a dermatological disorder, commonly known as hair loss, which affects up to half of the Caucasian male population by middle age, and almost all (95% Caucasian men by old age. Considering that alopecia affects so many people and that there is currently no scientifically proven treatment with few side effects, new drug-delivery systems able to improve alopecia therapy are urgently required. With this purpose in mind, the present study aimed to develop lipid nanoparticles (nanostructured lipid carriers with the ability to incorporate and deliver anti-alopecia active compounds (minoxidil and finasteride into the dermis and hair follicles. Lipid nanoparticles, prepared by ultrasonication method, showed mean particle sizes around 200 nm, which is sufficient for reaching the dermis and hair follicles, and zeta potential values around -30 mV, which indicates good physical stability. Over 28 days of storage, no significant variations in these parameters were observed, which indicates that all nanoformulations are stable in storage over that period. Cryo-scanning electron microscope measurements showed that all the lipid nanoparticles exhibited a spherical shape and a smooth surface regardless of their composition. Differential scanning calorimetry studies allowed the determination of phase transition temperatures and confirmed the recrystallization of the lipid nanoparticles (recrystallization index between 11% and 86%. A high loading efficiency was achieved for finasteride (between 70% and 90%, while less than 30% was

Expansion of the spectrum of ITGB6-related disorders to adolescent alopecia, dentogingival abnormalities and intellectual disability.

Science.gov (United States)

Ansar, Muhammad; Jan, Abid; Santos-Cortez, Regie Lyn P; Wang, Xin; Suliman, Muhammad; Acharya, Anushree; Habib, Rabia; Abbe, Izoduwa; Ali, Ghazanfar; Lee, Kwanghyuk; Smith, Joshua D; Nickerson, Deborah A; Shendure, Jay; Bamshad, Michael J; Ahmad, Wasim; Leal, Suzanne M

2016-08-01

Alopecia with mental retardation (APMR) is a very rare disorder. In this study, we report on a consanguineous Pakistani family (AP91) with mild-to-moderate intellectual disability, adolescent alopecia and dentogingival abnormalities. Using homozygosity mapping, linkage analysis and exome sequencing, we identified a novel rare missense variant c.898G>A (p.(Glu300Lys)) in ITGB6, which co-segregates with the phenotype within the family and is predicted to be deleterious. Structural modeling shows that Glu300 lies in the β-propeller domain, and is surrounded by several residues that are important for heterodimerization with α integrin. Previous studies showed that ITGB6 variants can cause amelogenesis imperfecta in humans, but patients from family AP91 who are homozygous for the c.898G>A variant present with neurological and dermatological features, indicating a role for ITGB6 beyond enamel formation. Our study demonstrates that a rare deleterious variant within ITGB6 causes not only dentogingival anomalies but also intellectual disability and alopecia.

Treatment of alopecia areata with the 308-nm xenon chloride excimer laser: case report of two successful treatments with the excimer laser.

Science.gov (United States)

Gundogan, Cuneyt; Greve, Bärbel; Raulin, Christian

2004-01-01

Alopecia areata is a common disease of unknown etiology; it causes significant cosmetic and psycho-social distress for most of the people it affects. We report on an innovative form of treatment in two patients with typical alopecia areata on the capillitium. We successfully treated two patients whose alopecia areata had worsened progressively for 3 and 14 weeks. The treatment involved the use of a 308 nm xenon chloride excimer laser (dosage 300-2,300 mJ/cm(2) per session). After 11 and 12 sessions within a 9-week and 11-week period, the entire affected focus showed homogenous and thick regrowth. No relapse was observed during the follow-up period of 5 and 18 months. The use of the excimer laser is an effective, elegant, and safe means of treatment and has good tolerability. Analogous to topical treatment of alopecia areata, the immunosuppressive mechanism of the excimer laser can be interpreted as an induction of T-cell apoptosis. This new means of treatment has yet to be discussed in medical literature. Further studies with greater numbers are needed to assess its potential more precisely and evaluate the excimer laser in treating alopecia areata. Copyright 2004 Wiley-Liss, Inc.

Correlation between serum IL-17A level and SALT score in patients with alopecia areata before and after NB-UVB therapy.

Science.gov (United States)

Morsy, Hanan; Maher, Reham; Negm, Dalia

2018-06-01

There is strong evidence that alopecia areata is of immunological background; Interleukin-17 (IL-17) is a Th17 pro-inflammatory cytokine that has been allied to the pathogenesis of different autoimmune and inflammatory diseases. This study aimed to measure serum IL-17A in patients with alopecia areata, and to study associations between IL-17A levels and disease severity before and after Narrowband-Ultraviolet B (NB-UVB), patient gender and age. Twenty patients with AA of the scalp were treated with (NB-UVB), and 15 healthy subjects' age and sex matched were enrolled as controls. Patients were assessed clinically by SALT score. Assay of serum levels of IL-17A by ELISA was done in patients and controls. The mean level of IL-17A was (15.63 Â ± 10.89 Pg/mL) in AA patient group, and (16.50 Â ± 5.02 Pg/mL) in control group. No statistically significant correlation was detected between SALT score and IL-17A level before (NB-UVB) treatment while a significant negative correlation between SALT score and IL-17A level was observed after treatment (r = -.448, P = .047). Mean SALT score for patients was (14.03 Â ± 13.48), and correlated positively with age (r = .446, P = .049). Although (NB-UVB) is an immune-modulatory type of treatment for alopecia areata of mild efficacy especially if it's used alone, it has shown significant decrease in serum IL-17A level among patients, and correlation to disease severity. © 2018 Wiley Periodicals, Inc.

[Central aleolar choroidal dystrophy in sibilings coexisting with alopecia].

Science.gov (United States)

Brydak-Godowska, Joanna; Dróbecka-Brydak, Ewa; Paćkowska, Maria; Kecik, Dariusz

2007-01-01

Central areolar choroidal dystrophy is localized in macular region and is characterized by atrophy of pigment epithelium, photoreceptors and choriocapillaris. This paper presents the history of two sibilings at the age of 23 and 30, with central aleolar choroidal dystrophy coexisting with alopecia. The results of erg, eog and fluorescein angiography are presented. The results of therapy for glaucoma associated with the Sturge-Weber syndrome are often disappointing.

Ichthyosis follicularis with alopecia and photophobia (IFAP syndrome

Directory of Open Access Journals (Sweden)

Rai Vandana

2006-01-01

Full Text Available A 12-year-old boy born of a nonconsanguineous marriage presented with dry rough skin and photophobia since birth. His growth and developmental milestones were normal and there was no history of any neurological problem, hearing deficit or scarring around the hair follicles. Cutaneous examination revealed diffuse thinning of scalp hair with loss of eyebrows and eyelashes and a sandpapery texture of the skin all over the body, suggestive of ichthyosis follicularis with alopecia and photophobia syndrome.

Androgenetic alopecia: new insights into the pathogenesis and mechanism of hair loss

Science.gov (United States)

Sinclair, Rodney; Torkamani, Niloufar; Jones, Leslie

2015-01-01

The hair follicle is a complete mini-organ that lends itself as a model for investigation of a variety of complex biological phenomena, including stem cell biology, organ regeneration and cloning.  The arrector pili muscle inserts into the hair follicle at the level of the bulge- the epithelial stem cell niche.  The arrector pili muscle has been previously thought to be merely a bystander and not to have an active role in hair disease. Computer generated 3D reconstructions of the arrector pili muscle have helped explain why women with androgenetic alopecia (AGA) experience diffuse hair loss rather than the patterned baldness seen in men.  Loss of attachment between the bulge stem cell population and the arrector pili muscle also explains why miniaturization is irreversible in AGA but not alopecia areata. A new model for the progression of AGA is presented. PMID:26339482

Androgenetic alopecia: An update

Directory of Open Access Journals (Sweden)

Feroze Kaliyadan

2013-01-01

Full Text Available Androgenetic alopecia (AGA is one of the commonest reasons for dermatological consultation. Over the last few years our understanding of the pathophysiology of AGA has improved and this has paved way for better diagnostic and therapeutic options. Recent research has dwelled on the role of stem cells in the pathophysiology of AGA and has also identified newer genetic basis for the condition. Dermoscopy/trichoscopy has emerged as a useful diagnostic tool for AGA. While the major treatment options continue to be topical minoxidil, systemic Finasteride and hair transplantations, newer modalities are under investigation. Specific diagnostic and treatment recommendations have also been developed on evidence based principles. This article reviews the recent concepts in relation to AGA. With regards to the pathophysiology we have tried to stress on recent knowledge of the molecular and genetic basis of AGA. We have emphasized on an evidence based approach for treatment and diagnosis.

Child, parent, and parent-child emotion narratives: implications for developmental psychopathology.

Science.gov (United States)

Oppenheim, David

2006-01-01

Studies using narratives with children and parents offer ways to study affective meaning-making processes that are central in many theories of developmental psychopathology. This paper reviews theory regarding affective meaning making, and argues that narratives are particularly suited to examine such processes. The review of narrative studies and methods is organized into three sections according to the focus on child, parent, and parent-child narratives. Within each focus three levels of analysis are considered: (a) narrative organization and coherence, (b) narrative content, and (c) the behavior/interactions of the narrator(s). The implications of this research for developmental psychopathology and clinical work are discussed with an emphasis on parent-child jointly constructed narratives as the meeting point of individual child and parent narratives.

Narrative Aversion: Challenges for the Illness Narrative Advocate.

Science.gov (United States)

Behrendt, Kathy

2017-02-01

Engaging in self-narrative is often touted as a powerful antidote to the bad effects of illness. However, there are various examples of what may broadly be termed "aversion" to illness narrative. I group these into three kinds: aversion to certain types of illness narrative; aversion to illness narrative as a whole; and aversion to illness narrative as an essentially therapeutic endeavor. These aversions can throw into doubt the advantages claimed for the illness narrator, including the key benefits of repair to the damage illness does to identity and life-trajectory. Underlying these alleged benefits are two key presuppositions: that it is the whole of one's life that is narratively unified, and that one's identity is inextricably bound up with narrative. By letting go of these assumptions, illness narrative advocates can respond to the challenges of narrative aversions. © The Author 2016. Published by Oxford University Press, on behalf of The Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Life Themes and Interpersonal Motivational Systems in the Narrative Self-construction

Science.gov (United States)

Veglia, Fabio; Di Fini, Giulia

2017-01-01

What makes unique and unrepeatable individuals is their ability to write their own story attributing meaning, sharing it through narration, giving coherence to the information related to the interpersonal motivational systems, and creating alternative hierarchies to those biologically provided by the genetic code. Through clinical narratives and narrative literature, we can observe the recurrence of specific topics, across time and different cultures. Hence, we wondered whether there are some evolutionary suggestions that guide us in the construction of the narrative-autobiographical contents. In this article we proposed a theoretical-clinical hypothesis about the existence of a biological disposition to identify as fundamental six Life Themes (LTs) that contribute to defining the image of the self and the world: Love, Personal Value, Power, Justice, Truth, and Freedom. Besides the innumerable narratives dependent upon context, there may be many ways of telling stories that, instead, would be reported to these few essential themes. A narrative review of the literature about these concepts follows the systematic explanation of the perspective about the LTs as attractors of meaning. The manuscript considers also the process of co-construction of meanings within the interpersonal relationships and the influences of these on the narratives. In particular, we focused on the importance of episodic and autobiographical memory related to the attachment and significant figures, in the construction of the personal story and the LTs. We also explained the possible clinical implications of the theoretical hypothesis of LTs. Within clinical conversations, the LTs could be expressed rigidly or, otherwise, in a confused way. The lack of narrative integration may lead to the dominance of chaos or rigidity that generates suffering. A better comprehension of the LTs in patients’ narrations could be useful to identify a narrative profile about the areas of greatest suffering

Prevalence and spatio-temporal variation of an alopecia syndrome in polar bears (Ursus maritimus) of the southern Beaufort Sea

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Atwood, Todd C.; Peacock, Elizabeth; Burek, K.A.; Shearn-Bochsler, Valerie I.; Bodenstein, Barbara L.; Beckmen, Kimberlee B.; Durner, George M.

2015-01-01

Alopecia (hair loss) has been observed in several marine mammal species and has potential energetic consequences for sustaining a normal core body temperature, especially for Arctic marine mammals routinely exposed to harsh environmental conditions. Polar bears (Ursus maritimus) rely on a thick layer of adipose tissue and a dense pelage to ameliorate convective heat loss while moving between sea ice and open water. From 1998 to 2012, we observed an alopecia syndrome in polar bears from the southern Beaufort Sea of Alaska that presented as bilaterally asymmetrical loss of guard hairs and thinning of the undercoat around the head, neck, and shoulders, which, in severe cases, was accompanied by exudation and crusted skin lesions. Alopecia was observed in 49 (3.45%) of the bears sampled during 1,421 captures, and the apparent prevalence varied by years with peaks occurring in 1999 (16%) and 2012 (28%). The probability that a bear had alopecia was greatest for subadults and for bears captured in the Prudhoe Bay region, and alopecic individuals had a lower body condition score than unaffected individuals. The cause of the syndrome remains unknown and future work should focus on identifying the causative agent and potential effects on population vital rates.

Prevalence and spatio-temporal variation of an alopecia syndrome in polar bears (Ursus maritimus) of the southern Beaufort Sea.

Science.gov (United States)

Atwood, Todd; Peacock, Elizabeth; Burek-Huntington, Kathy; Shearn-Bochsler, Valerie; Bodenstein, Barbara; Beckmen, Kimberlee; Durner, George

2015-01-01

Alopecia (hair loss) has been observed in several marine mammal species and has potential energetic consequences for sustaining a normal core body temperature, especially for Arctic marine mammals routinely exposed to harsh environmental conditions. Polar bears (Ursus maritimus) rely on a thick layer of adipose tissue and a dense pelage to ameliorate convective heat loss while moving between sea ice and open water. From 1998 to 2012, we observed an alopecia syndrome in polar bears from the southern Beaufort Sea of Alaska that presented as bilaterally asymmetrical loss of guard hairs and thinning of the undercoat around the head, neck, and shoulders, which, in severe cases, was accompanied by exudation and crusted skin lesions. Alopecia was observed in 49 (3.45%) of the bears sampled during 1,421 captures, and the apparent prevalence varied by years with peaks occurring in 1999 (16%) and 2012 (28%). The probability that a bear had alopecia was greatest for subadults and for bears captured in the Prudhoe Bay region, and alopecic individuals had a lower body condition score than unaffected individuals. The cause of the syndrome remains unknown and future work should focus on identifying the causative agent and potential effects on population vital rates.

Female Pattern Hair Loss: a clinical and pathophysiological review.

Science.gov (United States)

Ramos, Paulo Müller; Miot, Hélio Amante

2015-01-01

Female Pattern Hair Loss or female androgenetic alopecia is the main cause of hair loss in adult women and has a major impact on patients' quality of life. It evolves from the progressive miniaturization of follicles that lead to a subsequent decrease of the hair density, leading to a non-scarring diffuse alopecia, with characteristic clinical, dermoscopic and histological patterns. In spite of the high frequency of the disease and the relevance of its psychological impact, its pathogenesis is not yet fully understood, being influenced by genetic, hormonal and environmental factors. In addition, response to treatment is variable. In this article, authors discuss the main clinical, epidemiological and pathophysiological aspects of female pattern hair loss.

Valuing narrative in the care of older people: a framework of narrative practice for older adult residential care settings.

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Buckley, Catherine; McCormack, Brendan; Ryan, Assumpta

2014-09-01

To report on the development of a framework of narrative practice, in residential care settings for older people. Residential care settings for older people provide care for people who are no longer able to live in their own home. To date, the impact and structure of nursing practice on care provision in these settings has proved difficult to conceptualise within a specific nursing theory framework. A hermeneutic approach incorporating narrative methods was used. Forty-six narrative interviews with older people in residential care were secondary-analysed for key themes through a three-stage process: by the first author, four focus groups of 12 clinical nurse managers and two independent experts. Themes were also derived from a focus group of eight residents who explored person-centredness and narrative. Finally, the combined findings were used to derive a single set of themes. The secondary data analysis process led to the development of a framework of narrative practice for the care of older people in residential settings. The framework is influenced by narrative enquiry, person-centred practice and practice development. It has four pillars, prerequisites, care processes, care environment and narrative aspects of care. To operationalise the framework of narrative practice, three narrative elements, narrative knowing, narrative being and narrative doing, need to be considered. Working with the foundational pillars and the narrative elements would enable staff to 'work in a storied way' and provide person-centred outcomes and a narrative informed philosophy of care for older adults in residential care. This framework provides nurses with a template that confirms the identity of the older person taking account of their biography. The framework outlines an approach that provides staff with a template on how to provide person-centred care in a narrative way. © 2013 John Wiley & Sons Ltd.

The effectiveness of finasteride and dutasteride used for 3 years in women with androgenetic alopecia

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Ids H Boersma

2014-01-01

Full Text Available Background: The effectiveness of finasteride and dutasteride in women with androgenetic alopecia has been the subject of debate. Aim: To evaluate the effectiveness of finasteride and dutasteride on hair loss in women with androgenetic alopecia over a period of 3 years. Methods: From a database containing systematically retrieved data on 3500 women treated for androgenetic alopecia between 2002 and 2012 with finasteride 1.25 mg or dutasteride 0.15 mg, a random sample stratified for age and type of medication was taken to yield 30 women in two age categories: below and above 50 years, and for both medications. Hair thickness of the three thinnest hairs was measured from standardized microscopic images at three sites of the scalp at the start of the treatment and after 3 years of continuous medication intake. The macroscopic images were evaluated independently by three European dermatologists/hair experts. The diagnostic task was to identify the image displaying superior density of the hair. Results: Both age categories showed a statistically significant increase in hair thickness from baseline over the 3-year period for finasteride and dutasteride (signed rank test, P = 0.02. Hair thickness increase was observed in 49 (81.7% women in the finasteride group and in 50 (83.3% women in the dutasteride group. On average, the number of post-treatment images rated as displaying superior density was 124 (68.9% in the finasteride group, and 118 (65.6% in the dutasteride group. Dutasteride performed statistically significantly better than finasteride in the age category below 50 years at the central and vertex sites of the scalp. Conclusions: Finasteride 1.25 mg and dutasteride 0.15 mg given daily for 3 years effectively increased hair thickness and arrested further deterioration in women with androgenetic alopecia.

Dictionary construction and identification of possible adverse drug events in Danish clinical narrative text.

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Eriksson, Robert; Jensen, Peter Bjødstrup; Frankild, Sune; Jensen, Lars Juhl; Brunak, Søren

2013-01-01

Drugs have tremendous potential to cure and relieve disease, but the risk of unintended effects is always present. Healthcare providers increasingly record data in electronic patient records (EPRs), in which we aim to identify possible adverse events (AEs) and, specifically, possible adverse drug events (ADEs). Based on the undesirable effects section from the summary of product characteristics (SPC) of 7446 drugs, we have built a Danish ADE dictionary. Starting from this dictionary we have developed a pipeline for identifying possible ADEs in unstructured clinical narrative text. We use a named entity recognition (NER) tagger to identify dictionary matches in the text and post-coordination rules to construct ADE compound terms. Finally, we apply post-processing rules and filters to handle, for example, negations and sentences about subjects other than the patient. Moreover, this method allows synonyms to be identified and anatomical location descriptions can be merged to allow appropriate grouping of effects in the same location. The method identified 1 970 731 (35 477 unique) possible ADEs in a large corpus of 6011 psychiatric hospital patient records. Validation was performed through manual inspection of possible ADEs, resulting in precision of 89% and recall of 75%. The presented dictionary-building method could be used to construct other ADE dictionaries. The complication of compound words in Germanic languages was addressed. Additionally, the synonym and anatomical location collapse improve the method. The developed dictionary and method can be used to identify possible ADEs in Danish clinical narratives.

Alopecia Areata and Discoid Lupus Erythematosus in a Patient with Vitiligo

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K Pavithran

1986-01-01

Full Text Available A 52 year old male who had been having - vitiligo for 20 years, developed alopecia universalis since 4 years and disseminated discoid IUPUS erythematosus since 2 years. The coexistence of these three diseases in the same patient lends credence to the contention that auto′ unity may play a role in the pathogenesis of these diseases.

Alopecia areata ofiásia na infância: do diagnóstico ao tratamento

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José Otávio Alquezar Gozzano

2016-10-01

Full Text Available Introdução: Entre as alopecias mais comuns na infância está a alopecia areata (AA, uma afecção crônica dos folículos pilosos, de etiologia auto-imune e genética. Apresenta-se pela queda de pelos, devido a interrupção de sua síntese, sem a atrofia dos folículos, por isso é reversível. AA afeta ambos os sexos e inicia- se em qualquer idade; porém, 60% dos primeiros episódios ocorrem entre 5 e 20 anos. AA manifesta-se por placas de alopecia assintomáticas, arredondadas, sem inflamação, podendo afetar qualquer área com folículos pilosos, frequentemente o couro cabeludo. Sinal de tração positivo, pelos cadavéricos e penugem branca no exame físico da fase aguda auxiliam o diagnóstico. AA é classificada como atípica e clássica, esta última pode ser: placa única, placas múltiplas, AA total, ou AA ofiásica (AAO. AAO consiste na perda de cabelos na linha de implantação temporooccipital, atingindo as bordas inferiores do couro cabeludo; seu diagnóstico é clinico devendo ser diferenciado de Tinha do couro cabeludo, pseudopelada de Brocq e tricotilomania. O tratamento para AAO é sintomático e não altera o prognóstico, sendo utilizados principalmente corticoides tópicos, infiltrações intralesionais, antralina e minoxidil. Objetivo: Relatar caso de AAO na infância. Relato do caso: Feminina, 13 anos, com perda de cabelos há 4 anos e piora há 6 meses. Ao exame: área extensa de alopecia em região temporoocciptal até margem inferior de implantação do couro cabeludo. Sinal de tração positivo na periferia da área de alopecia. Hipótese diagnóstica: AAO. Terapia: infiltração de corticoide. Metodologia: Paciente atendida em ambulatório e revisão de literatura. Conclusão: Por acometer sobretudo os cabelos, AA afeta a autoestima e os aspectos psicológicos, principalmente das crianças, que crescem em meio propício a julgamentos e rejeição social. Assim, é importante a intervenção terapêutica precoce

[Narrative Pedagogy in Nursing Education: The Essence of Clinical Nursing Process Recording].

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Chao, Yu-Mei Y; Chiang, Hsien-Hsien

2017-02-01

Clinical nursing process recording (CNPR) has been shown to be an effective tool for facilitating student-centered teaching and learning in nursing education. Yet, the essence and process of this tool have yet to be sufficiently explored and clarified. To explore the essence of CNPR in the contexts of clinical teaching and learning. Reflective analysis was used as the phenomenological approach to analyze the qualitative data, which were transcribed from the oral responses of the six participants who were attending the Clinical Nursing Education Forum. A total of five sessions of the Clinical Nursing Education Forums were conducted. The content of the Clinical Nursing Education Forums consisted of a series of 12 narrative writings of CNPR that were written by a senior student and read and commented on by the student's clinical instructor. Three groups of the essence and process of clinical teaching and learning were inductively identified as: (a) mobilizing autonomous, self-directed learning behavior from self-writing and re-storying; (b) establishing the student-instructor dialogical relationship from mutual localization; and (c) co-creating a learning environment in education and in clinical practice. When used as an interactive teaching and learning tool, CNPR promotes mutual understanding by re-locating the self in the coexisting roles of student nurse, instructor, and patient in a series of nursing care situations. This re-location facilitates students' self-directed learning, enhances the abilities of asking question, waiting for and accompany with the instructor; and promotes the self-care capabilities of patients.

Follicular delivery of spironolactone via nanostructured lipid carriers for management of alopecia

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Shamma RN

2014-11-01

Full Text Available Rehab Nabil Shamma, Mona Hassan AburahmaDepartment of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, EgyptAbstract: Spironolactone (SL is a US Food and Drug Administration-approved drug for the treatment of hypertension and various edematous conditions. SL has gained a lot of attention for treating androgenic alopecia due to its potent antiandrogenic properties. Recently, there has been growing interest for follicular targeting of drug molecules for treatment of hair and scalp disorders using nanocolloidal lipid-based delivery systems to minimize unnecessary systemic side effects associated with oral drug administration. Accordingly, the objective of this study is to improve SL efficiency and safety in treating alopecia through the preparation of colloidal nanostructured lipid carriers (NLCs for follicular drug delivery. SL-loaded NLCs were prepared by an emulsion solvent diffusion and evaporation method using 23 full factorial design. All of the prepared formulations were spherical in shape with nanometric size range (215.6–834.3 nm and entrapment efficiency >74%. Differential scanning calorimetry thermograms and X-ray diffractograms revealed that SL exists in amorphous form within the NLC matrices. The drug release behavior from the NLCs displayed an initial burst release phase followed by sustained release of SL. Confocal laser scanning microscopy confirmed the potential of delivering the fluorolabeled NLCs within the follicles, suggesting the possibility of using SL-loaded NLCs for localized delivery of SL into the scalp hair follicles.Keywords: spironolactone, androgenic alopecia, nanostructured lipid carriers, follicular targeting, confocal laser scanning microscopy

A narrative analysis of helplessness in depression.

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Vanheule, Stijn; Hauser, Stuart T

2008-12-01

The transcripts of semistructured clinical interviews with forty psychiatrically hospitalized adolescents were subjected to narrative analysis in an effort to map the logic of their explanations as they spontaneously talked about helplessness experiences, and to determine how helplessness is embedded in broader story lines. Three types of narrative composition were discerned, and are discussed by means of excerpts from the interviews. In a first and predominant type of narrative, a disturbing confrontation with another is pivotal: the other's intentions are obscure; this frightens the narrator, who does not know what to do. Helplessness arises as a direct result of not knowing how to manage the "unbearable riddle" of the other's intentions. In the second, more marginal type of narrative, helplessness is embedded in an account of emptiness and boredom. The protagonist relates enduring experiences of emptiness due to loss and the suffering consequent on it. In the third, also more marginal type of narrative, helplessness is framed in a context of failure: the protagonist adheres to strict standards, feels he or she has fallen short, and concludes that he or she is a failure. Only the first type of narrative is significantly related to the psychiatric diagnoses of mood disorder and major depression.

At the Membranes of Care: Stories in Narrative Medicine

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Charon, Rita

2012-01-01

Recognizing clinical medicine as a narrative undertaking fortified by learnable skills in understanding stories has helped doctors and teachers to face otherwise vexing problems in medical practice and education in the areas of professionalism, medical interviewing, reflective practice, patient-centered care, and self-awareness. The emerging practices of narrative medicine give clinicians fresh methods with which to make contact with patients and to come to understand their points of view. This essay provides a brief review of narrative theory regarding the structure of stories, suggesting that clinical texts contain and can reveal information in excess of their plots. Through close reading of the form and content of two clinical texts—an excerpt from a medical chart and a portion of an audio-taped interview with a medical student—and a reflection on a short section of a modernist novel, the author suggests ways to expand conventional medical routines of recognizing the meanings of patients' situations. The contributions of close reading and reflective writing to clinical practice may occur by increasing the capacities to perceive and then to represent the perceived, thereby making available to a writer that which otherwise might remain out of awareness. A clinical case is given to exemplify the consequences in practices of adopting the methods of narrative medicine. A metaphor of the activated cellular membrane is proposed as a figure for the effective clinician/patient contact. PMID:22373630

Power and promise of narrative for advancing physical therapist education and practice.

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Greenfield, Bruce H; Jensen, Gail M; Delany, Clare M; Mostrom, Elizabeth; Knab, Mary; Jampel, Ann

2015-06-01

This perspective article provides a justification for and an overview of the use of narrative as a pedagogical tool for educators to help physical therapist students, residents, and clinicians develop skills of reflection and reflexivity in clinical practice. The use of narratives is a pedagogical approach that provides a reflective and interpretive framework for analyzing and making sense of texts, stories, and other experiences within learning environments. This article describes reflection as a well-established method to support critical analysis of clinical experiences; to assist in uncovering different perspectives of patients, families, and health care professionals involved in patient care; and to broaden the epistemological basis (ie, sources of knowledge) for clinical practice. The article begins by examining how phronetic (ie, practical and contextual) knowledge and ethical knowledge are used in physical therapy to contribute to evidence-based practice. Narrative is explored as a source of phronetic and ethical knowledge that is complementary but irreducible to traditional objective and empirical knowledge-the type of clinical knowledge that forms the basis of scientific training. The central premise is that writing narratives is a cognitive skill that should be learned and practiced to develop critical reflection for expert practice. The article weaves theory with practical application and strategies to foster narrative in education and practice. The final section of the article describes the authors' experiences with examples of integrating the tools of narrative into an educational program, into physical therapist residency programs, and into a clinical practice. © 2015 American Physical Therapy Association.

An Open-Label Evaluator Blinded Study of the Efficacy and Safety of a New Nutritional Supplement in Androgenetic Alopecia: A Pilot Study.

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Nichols, Anna J; Hughes, Olivia Bosshardt; Canazza, Agnese; Zaiac, Martin N

2017-02-01

Objective: To evaluate the effectiveness of a novel oral supplement, Forti5 ® , containing green tea extract, omega 3 and 6 fatty acids, cholecalciferol, melatonin, beta-sitosterol, and soy isoflavones, and in the management of subjects with androgenetic alopecia. Design: A prospective case series of 10 subjects. Setting: Open-label, evaluator-blinded, proof-of-concept study. Participants: Ten adult subjects with androgenetic alopecia completed the study. Subjects were not allowed to use oral or topical hair growth products in the 24 weeks preceding the study or during the study. The nutritional supplement was administered at a dosage of two tablets daily for 24 weeks. Measurements: Clinical evaluations were performed at baseline and at 24 weeks. Efficacy was evaluated using hair mass index measured by cross section trichometer, terminal hair count measured with dermoscopy and Investigator Global Photography Assessment. Results: Overall 80 percent of subjects (8/10) were rated as improved after 24 weeks of supplementation (mean change of +1.4 equivalent to slightly-to-moderately increased). Forty percent of subjects (4/10) were rated as moderately improved (2+), and 10 percent (1/10) were rated as greatly improved (3+). There was a significant improvement in terminal hair count (mean increase of 5.9% or 4.2 more terminal hairs in the area examined, p =0.014) and in Hair Mass Index (mean increase of 9.5% or 4.5 higher Hair Mass Index, p =0.003). Conclusion: These preliminary results indicate that Forti5 ® a novel nutritional supplement that contains cholecalciferol, omega 3 and 6 fatty acids, melatonin, antioxidants, and botanical 5-alpha reductase inhibitors, may be a useful adjunct in the treatment of androgenetic alopecia.

Framing Effects in Narrative and Non-Narrative Risk Messages.

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Steinhardt, Joseph; Shapiro, Michael A

2015-08-01

Narrative messages are increasingly popular in health and risk campaigns, yet gain/loss framing effects have never been tested with such messages. Three experiments examined framing in narrative messages. Experiment 1 found that only the character's decision, not framing, influenced judgments about characters in a narrative derived from a prospect theory context. Experiment 2 found that a framing effect that occurred when presented in a decision format did not occur when the same situation was presented as a narrative. Using a different story/decision context, Experiment 3 found no significant difference in preference for surgery over radiation therapy in a narrative presentation compared to a non-narrative presentation. The results suggest that health and risk campaigns cannot assume that framing effects will be the same in narrative messages and non-narrative messages. Potential reasons for these differences and suggestions for future research are discussed. © 2015 Society for Risk Analysis.

Alopecia Areata of the Beard: A Review of the Literature.

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Cervantes, Jessica; Fertig, Raymond M; Maddy, Austin; Tosti, Antonella

2017-12-01

Alopecia areata (AA) is a T-cell mediated autoimmune disorder in which inflammatory cells attack the hair follicle, resulting in round, well-circumscribed patches of noncicatricial hair loss in normal appearing skin. AA affecting the beard area is well known and is referred to as AA of the beard (BAA) or AA barbae when involvement is limited exclusively to the beard. BAA has been documented in a select number of studies. We review the literature and discuss the clinical features, epidemiology, diagnosis, and treatment of BAA. Clinical presentation of BAA can vary and manifest as single small areas of hair loss, multiple small or large simultaneous focuses, or total hair loss. Most patients are middle-aged males with focal patches of round or oval hair loss, mostly localized along the jawline. Patches are characteristically well circumscribed and smooth with white hair present at the periphery. Dermoscopic features of BAA include yellow dots, broken hair, and short vellus hairs. BAA may be associated with other autoimmune disorders, including atopic dermatitis, vitiligo, and psoriasis. Many treatment modalities are available for BAA, and selection of a therapy depends on several factors, including disease activity, extent of area affected, duration of disease, and age of the patient. Topical corticosteroids are most commonly used as initial treatment, followed by intralesional steroids. Other therapeutic modalities are discussed.

SERUM-CONCENTRATIONS OF Dehydroepyandrosterone-sulfate IN MEN WITH ANDROGENETIC ALOPECIA

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Ani Tsvetanova

2004-10-01

Full Text Available Androgenetic alopecia (AA is considered as a genetically determinate androgen (DHT-dependent disorder. Theoretically Dehydroepyandrosterone-sulfate (DHEA-S is the first main metabolite in the androgen metabolism. The aim of the study was to determine the serum-levels of DHEA-S (DHEA-S(s in patients with AA and the possible correlation between clinical stage of AA and DHEA-S(s. Forty-four men (37 with male pattern baldness and 7 healthy controls aged 19 to 55 had DHEA-S(s measured. Determination of the hormone was performed by standard radioimmunoassay. Only nine of the men with AA showed high levels of DHEA-S(s. In 3 of the patients were detected a boundary high levels of DHEA-S(s. No correlation between the clinical stage of AA and DHEA-S(s -levels was established. There was relationship only between increase of the age and decrease of the concentrations of DHEA-S(s. In contrast to previous studies, in our investigation, no elevation of DHEA-S(s in men with AA was found. Our results indirect support the current understanding of the importance of some follicular enzymes (STS, 3-beta-HSD, 17-beta-HSD etc. that could increase the amount of the alternative DHT-sources in AA, as well as the theory for the “endocrinology of hair follicle”.

Interface, information, interaction: a narrative review of design and functional requirements for clinical decision support.

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Miller, Kristen; Mosby, Danielle; Capan, Muge; Kowalski, Rebecca; Ratwani, Raj; Noaiseh, Yaman; Kraft, Rachel; Schwartz, Sanford; Weintraub, William S; Arnold, Ryan

2018-05-01

Provider acceptance and associated patient outcomes are widely discussed in the evaluation of clinical decision support systems (CDSSs), but critical design criteria for tools have generally been overlooked. The objective of this work is to inform electronic health record alert optimization and clinical practice workflow by identifying, compiling, and reporting design recommendations for CDSS to support the efficient, effective, and timely delivery of high-quality care. A narrative review was conducted from 2000 to 2016 in PubMed and The Journal of Human Factors and Ergonomics Society to identify papers that discussed/recommended design features of CDSSs that are associated with the success of these systems. Fourteen papers were included as meeting the criteria and were found to have a total of 42 unique recommendations; 11 were classified as interface features, 10 as information features, and 21 as interaction features. Features are defined and described, providing actionable guidance that can be applied to CDSS development and policy. To our knowledge, no reviews have been completed that discuss/recommend design features of CDSS at this scale, and thus we found that this was important for the body of literature. The recommendations identified in this narrative review will help to optimize design, organization, management, presentation, and utilization of information through presentation, content, and function. The designation of 3 categories (interface, information, and interaction) should be further evaluated to determine the critical importance of the categories. Future work will determine how to prioritize them with limited resources for designers and developers in order to maximize the clinical utility of CDSS. This review will expand the field of knowledge and provide a novel organization structure to identify key recommendations for CDSS.

Original papers A study on efficacy of 308 nm excimer light therapy in alopecia areata

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Zo Nun Sanga

2015-06-01

Full Text Available Introduction. Alopecia areata (AA is an autoimmune condition characterized by T-cell-mediated attack on hair follicles. Objective. Evaluation of efficacy of 308 nm excimer light in the treatment of alopecia areata. Material and methods. Patches of AA were treated twice weekly, but not on 2 consecutive days, with UVB excimer 308 nm light. In all patients, half of the AA patch was irradiated and the other half was spared, covered with a black rubber shield and taken as a control. Therapy was started with an initial dose of 300 mJ/cm 2 , with an incremental dose of 100 mJ/cm 2 at every sitting until fine erythema appeared. Results. At the end of the treatment, one patient (3.33% at the test site showed > 50% hair regrowth vs. none at the control site. After a 2-month post-treatment period, successful hair regrowth (grades 3 and 4 was seen in 12 patients at test sites and in 2 patients at control sites. The differences were statistically significant (p < 0.05. After 4 months successful hair regrowth (grades 3 and 4 was seen in 16 patients at test sites and in 5 patients at control sites. The differences were statistically significant (p 0.05. Conclusions. Excimer light has the potential to stimulate hair regrowth in patches of alopecia areata.

Dictionary construction and identification of possible adverse drug events in Danish clinical narrative text

Science.gov (United States)

Eriksson, Robert; Jensen, Peter Bjødstrup; Frankild, Sune; Jensen, Lars Juhl; Brunak, Søren

2013-01-01

Objective Drugs have tremendous potential to cure and relieve disease, but the risk of unintended effects is always present. Healthcare providers increasingly record data in electronic patient records (EPRs), in which we aim to identify possible adverse events (AEs) and, specifically, possible adverse drug events (ADEs). Materials and methods Based on the undesirable effects section from the summary of product characteristics (SPC) of 7446 drugs, we have built a Danish ADE dictionary. Starting from this dictionary we have developed a pipeline for identifying possible ADEs in unstructured clinical narrative text. We use a named entity recognition (NER) tagger to identify dictionary matches in the text and post-coordination rules to construct ADE compound terms. Finally, we apply post-processing rules and filters to handle, for example, negations and sentences about subjects other than the patient. Moreover, this method allows synonyms to be identified and anatomical location descriptions can be merged to allow appropriate grouping of effects in the same location. Results The method identified 1 970 731 (35 477 unique) possible ADEs in a large corpus of 6011 psychiatric hospital patient records. Validation was performed through manual inspection of possible ADEs, resulting in precision of 89% and recall of 75%. Discussion The presented dictionary-building method could be used to construct other ADE dictionaries. The complication of compound words in Germanic languages was addressed. Additionally, the synonym and anatomical location collapse improve the method. Conclusions The developed dictionary and method can be used to identify possible ADEs in Danish clinical narratives. PMID:23703825

Etyopathogenesis and Oxidative Stress Relationship in Mild Severe Alopecia Areata

OpenAIRE

Fadime Kilinç; Ayse Akbas; Ahu Yorulmaz; Sertaç Sener; Salim Neselioglu; Özcan Erel; Ahmet Metin

2017-01-01

Objective:Alopecia areata (AA) is a recurrent, autoimmune, inflammatory disease characterized by loss of scarless hair. The etiopathogenesis is not exactly known, however genetic, emotional, environmental factors and autoimmunity are accused. The aim of the study is to investigate the role of oxidative stress in the etiopathogenesis of AA. Methods:Thirty seven AA patients and thirty five healthy volunteers as control group were included in the study. Oxidative stress index (OSI) was calcu...

Characterizing the Pain Narratives of Parents of Youth with Chronic Pain

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Noel, Melanie; Beals-Erickson, Sarah E.; Law, Emily F.; Alberts, Nicole; Palermo, Tonya M.

2015-01-01

Objectives Questionnaire-based research has shown that parents exert a powerful influence on and are profoundly influenced by living with a child with chronic pain. Examination of parents' pain narratives through an observational lens offers an alternative approach to understanding the complexity of pediatric chronic pain; however, the narratives of parents of youth with chronic pain have been largely overlooked. The present study aimed to characterize the vulnerability- and resilience-based aspects of the pain narratives of parents of youth with chronic pain. Methods Pain narratives of 46 parents were recorded during the baseline session as part of two clinical trials evaluating a behavioral intervention for parents of youth with chronic pain. The narratives were coded for aspects of pain-related vulnerability and resilience. Results Using exploratory cluster analysis, two styles of parents’ pain narratives were identified. Distress narratives were characterized by more negative affect and an exclusively unresolved orientation towards the child’s diagnosis of chronic pain whereas resilience narratives were characterized by positive affect and a predominantly resolved orientation towards the child’s diagnosis. Preliminary support for the validity of these clusters was provided through our finding of differences between clusters in parental pain catastrophizing about child pain (helplessness). Discussion Findings highlight the multidimensional nature of parents’ experience of their child’s pain problem. Clinical implications in terms of assessment and treatment are discussed. PMID:26736026

Transforming the findings of narrative research into poetry.

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Edwards, Sharon Lorraine

2015-05-01

To offer dramatic poetry as representing findings from narrative research that is more accessible. This article is drawn from the author's doctorate work on how students' stories about their 'clinical' experiences can aid learning. Nursing students' stories of clinical practice experiences when engaged in the care of patients represented as dramatic poetry. Qualitative analytical approaches in narrative data analysis to provide a review of student stories from a variety of perspectives. This article illustrates a method for converting story data to poetry. It suggests that a range of audiences can learn from nursing students' stories of clinical practice when translated into dramatic poetry. Audiences can come close to understanding what students are experiencing in practice when engaged in the care of patients and learning from their practice experiences, when these experiences are expressed as dramatic poetry. Representing findings from narrative research as dramatic poetry can help audiences engage with nursing students' experiences at an emotional level. Enabling researchers and readers to become immersed in the poem transforming their understanding of what the students have learned.

Vitamin D-Dependent rickets Type II with alopecia: A rare case report

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Divya Vupperla

2018-01-01

Full Text Available Vitamin D-dependent rickets type II is a rare hereditary disorder. It occurs due to mutations in the gene chr. 12q12-q14, which codes for vitamin D receptor. End-organ resistance to 1,25-(OH2vitamin D3 and alopecia in severe cases are the characteristic features. We report a case of a 4-year-old boy with loss of hair over the scalp and body – first observed after 1 month of birth. The boy also developed difficulty in walking at the age of 2 year. On analysis, reduced serum calcium level (7.5 mg/dL and elevated alkaline phosphatase level (625 IU/L were reported. Initially, the treatment included intramuscularly administered single dose of 600,000 IU vitamin D, followed by 400 IU of vitamin D along with 1 g of supplemental calcium every day. Periodic follow-up was conducted for 2 months. Improvement was observed in the biochemical parameters and X-rays of the distal radial and ulnar metaphyses, although no improvement was observed in alopecia.

Use of the pulsed infrared diode laser (904 nm) in the treatment of alopecia areata.

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Waiz, Makram; Saleh, Anmar Z; Hayani, Raafa; Jubory, Samar O

2006-04-01

Alopecia areata is a rapid and complete loss of hair in one or several patches, usually on the scalp, affecting both males and females equally. It is thought to be an autoimmune disease which is treated with different modalities with variable success. Laser treatment of different wavelengths has been used in the management of this problem. To study the effect of the pulsed infrared diode laser (904 nm) in the treatment of alopecia areata.Methods. Sixteen patients with 34 resistant patches that had not responded to different treatment modalities for alopecia areata were enrolled in this study. In patients with multiple patches, one patch was left as a control for comparison. Patients were treated on a four-session basis, once a week, with a pulsed diode laser (904 nm) at a pulse rate of 40/s. A photograph was taken of each patient before and after treatment. The treated patients were 11 males (68.75%) and five females (31.25%). Their ages ranged between 4 and 50 years with a mean of 26.6+/-SD of +/-13.8, and the durations of their disease were between 12 months and 6 years with a mean of 13.43+/-SD of +/-18.34. Regrowth of hair was observed in 32 patches (94%), while only two patches (6%) failed to show any response. No regrowth of hair was observed in the control patches. The regrowth of hair appeared as terminal hair with its original color in 29 patches (90.6%), while three patches (9.4%) appeared as a white villous hair. In patients who showed response, the response was detected as early as 1 week after the first session in 24 patches (75%), while eight patients (25%) started to show response from the second session. The pulsed infrared diode laser is an effective mode of therapy with a high success rate for resistant patches of alopecia areata.

Narrativity and enaction: the social nature of literary narrative understanding.

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Popova, Yanna B

2014-01-01

This paper proposes an understanding of literary narrative as a form of social cognition and situates the study of such narratives in relation to the new comprehensive approach to human cognition, enaction. The particular form of enactive cognition that narrative understanding is proposed to depend on is that of participatory sense-making, as developed in the work of Di Paolo and De Jaegher. Currently there is no consensus as to what makes a good literary narrative, how it is understood, and why it plays such an irreplaceable role in human experience. The proposal thus identifies a gap in the existing research on narrative by describing narrative as a form of intersubjective process of sense-making between two agents, a teller and a reader. It argues that making sense of narrative literature is an interactional process of co-constructing a story-world with a narrator. Such an understanding of narrative makes a decisive break with both text-centered approaches that have dominated both structuralist and early cognitivist study of narrative, as well as pragmatic communicative ones that view narrative as a form of linguistic implicature. The interactive experience that narrative affords and necessitates at the same time, I argue, serves to highlight the active yet cooperative and communal nature of human sociality, expressed in the many forms than human beings interact in, including literary ones.

Narrativity and Enaction: The Social Nature of Literary Narrative Understanding

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Yanna B. Popova

2014-08-01

Full Text Available This paper proposes an understanding of literary narrative as a form of social cognition and situates the study of such narratives in relation to the new comprehensive approach to human cognition, enaction. The particular form of enactive cognition that narrative understanding is proposed to depend on is that of participatory sense-making, as developed in the work of Di Paolo and De Jaegher. Currently there is no consensus as to what makes a good literary narrative, how it is understood, and why it plays such an irreplaceable role in human experience. The proposal thus identifies a gap in the existing research on narrative by describing narrative as a form of intersubjective process of sense-making between two agents, a teller and a reader. It argues that making sense of narrative literature is an interactional process of co-constructing a story-world with a narrator. Such an understanding of narrative makes a decisive break with both text-centered approaches that have dominated both structuralist and early cognitivist study of narrative, as well as pragmatic communicative ones that view narrative as a form of linguistic implicature. The interactive experience that narrative affords and necessitates at the same time, I argue, serves to highlight the active yet cooperative and communal nature of human sociality, expressed in the many forms than human beings interact in, including literary ones.

The Cinematic Narrator: The Logic and Pragmatics of Impersonal Narration.

Science.gov (United States)

Burgoyne, Robert

1990-01-01

Describes "impersonal narration," an approach that defends the concept of the cinematic narrator as a logical and pragmatic necessity. Compares this approach with existing theories of the cinematic narrator, addressing disagreements in the field of film narrative theory. (MM)

Myopericytoma as an unusual cause of scarring alopecia in a child

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Ying-Fang Lin

2014-03-01

Full Text Available Myopericytoma is a benign tumor composed of myoid-appearing oval to spindle-shaped cells arranged in a concentric perivascular pattern of growth. It arises most commonly in the dermis or subcutaneous tissue of the extremities in adults, and presents as a well-circumscribed, slow-growing, painless firm tumor. We describe a case of myopericytoma with unusual clinical presentation as scarring alopecia in a 14-year-old girl without any underlying disease, who presented with a 2-month history of a pink patch with hair loss on her frontal scalp. Under the diagnosis of discoid lupus erythematosus, an incisional biopsy was also performed. The biopsy specimen revealed a myopericytoma characterized by a subcutaneous large vein-like structure surrounded by spindled, stellate, and cuboidal cells with multiple small branching vascular spaces. The overlying dermis was fibrotic with dilated vessels and the number of hair follicles was decreased. No features of lupus erythematosus were noted and a lupus band test was negative. Total excision was performed. No recurrence occurred in the following 2 years.

The role of dimensions of narrative engagement in narrative persuasion

NARCIS (Netherlands)

Graaf, A.M.; Hoeken, J.A.L.; Sanders, J.M.; Beentjes, J.W.J.

2009-01-01

Several models of narrative persuasion posit that a reader's phenomenological experience of a narrative plays a mediating role in the persuasive effects of the narrative. Because the narrative reading experience is multi-dimensional, this experiment investigates which dimensions of this experience -

The role of dimensions of narrative engagement in narrative persuasion

NARCIS (Netherlands)

Graaf, A. de; Hoeken, J.A.L.; Sanders, J.M.; Beentjes, J.W.J.

2009-01-01

Several models of narrative persuasion posit that a reader's phenomenological experience of a narrative plays a mediating role in the persuasive effects of the narrative. Because the narrative reading experience is multi-dimensional, this experiment investigates which dimensions of this experience –

Conventional and novel stem cell based therapies for androgenic alopecia

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Talavera-Adame D

2017-08-01

Full Text Available Dodanim Talavera-Adame,1 Daniella Newman,2 Nathan Newman1 1American Advanced Medical Corp. (Private Practice, Beverly Hills, CA, 2Western University of Health Sciences, Pomona, CA, USA Abstract: The prevalence of androgenic alopecia (AGA increases with age and it affects both men and women. Patients diagnosed with AGA may experience decreased quality of life, depression, and feel self-conscious. There are a variety of therapeutic options ranging from prescription drugs to non-prescription medications. Currently, AGA involves an annual global market revenue of US$4 billion and a growth rate of 1.8%, indicating a growing consumer market. Although natural and synthetic ingredients can promote hair growth and, therefore, be useful to treat AGA, some of them have important adverse effects and unknown mechanisms of action that limit their use and benefits. Biologic factors that include signaling from stem cells, dermal papilla cells, and platelet-rich plasma are some of the current therapeutic agents being studied for hair restoration with milder side effects. However, most of the mechanisms exerted by these factors in hair restoration are still being researched. In this review, we analyze the therapeutic agents that have been used for AGA and emphasize the potential of new therapies based on advances in stem cell technologies and regenerative medicine. Keywords: stem cells, stem cell therapies, hair follicle, dermal papilla, androgenic alopecia, laser, hair regeneration

The use of low-level light therapy in the treatment of androgenetic alopecia and female pattern hair loss.

Science.gov (United States)

Gupta, Aditya K; Daigle, Deanne

2014-04-01

Androgenetic alopecia (AGA) or female pattern hair loss (FPHL) is the most common form of hair loss in men and women. Despite its common occurrence, our understanding of the etiology of AGA and FPHL remains incomplete. As such, traditional therapies demonstrate modest efficacies and new therapies continue to be sought. Low-level light therapy (LLLT) is a relatively new technique used to promote hair growth in both men and women with AGA and FPHL. Currently, there exist several LLLT devices marketed for the treatment of alopecia, which claim to stimulate hair growth; yet marketing these devices only requires that safety, not efficacy, be established. A handful of studies have since investigated the efficacy of LLLT for alopecia with mixed results. These studies suffered from power, confounding and analysis issues which resulted in a high risk of bias in LLLT studies. Due to the paucity of well-conducted randomized controlled trials, the efficacy of LLLT devices remains unclear. Randomized controlled trials of LLLT conducted and reported according to the Consolidated Standards of Reporting Trials (CONSORT) statement would greatly increase the credibility of the evidence and clarify the ambiguity of the effectiveness of LLLT in the treatment of AGA and FPHL.

An Open-Label Evaluator Blinded Study of the Efficacy and Safety of a New Nutritional Supplement in Androgenetic Alopecia: A Pilot Study

OpenAIRE

Nichols, Anna J.; Hughes, Olivia Bosshardt; Canazza, Agnese; Zaiac, Martin N.

2017-01-01

Objective: To evaluate the effectiveness of a novel oral supplement, Forti5?, containing green tea extract, omega 3 and 6 fatty acids, cholecalciferol, melatonin, beta-sitosterol, and soy isoflavones, and in the management of subjects with androgenetic alopecia. Design: A prospective case series of 10 subjects. Setting: Open-label, evaluator-blinded, proof-of-concept study. Participants: Ten adult subjects with androgenetic alopecia completed the study. Subjects were not allowed to use oral o...

Numerical versus narrative: A comparison between methods to measure medical student performance during clinical clerkships.

Science.gov (United States)

Bartels, Josef; Mooney, Christopher John; Stone, Robert Thompson

2017-11-01

Medical school evaluations typically rely on both language-based narrative descriptions and psychometrically converted numeric scores to convey performance to the grading committee. We evaluated inter-rater reliability and correlation of numeric versus narrative evaluations for students on their Neurology Clerkship. 50 Neurology Clerkship in-training evaluation reports completed by their residents and faculty members at the University of Rochester School of Medicine were dissected into narrative and numeric components. 5 Clerkship grading committee members retrospectively gave new narrative scores (NNS) while blinded to original numeric scores (ONS). We calculated intra-class correlation coefficients (ICC) and their associated confidence intervals for the ONS and the NNS. In addition, we calculated the correlation between ONS and NNS. The ICC was greater for the NNS (ICC = .88 (95% CI = .70-.94)) than the ONS (ICC = .62 (95% CI = .40-.77)) Pearson correlation coefficient showed that the ONS and NNS were highly correlated (r = .81). Narrative evaluations converted by a small group of experienced graders are at least as reliable as numeric scoring by individual evaluators. We could allow evaluators to focus their efforts on creating richer narrative of greater value to trainees.

Narrative interviewing.

Science.gov (United States)

Anderson, Claire; Kirkpatrick, Susan

2016-06-01

Introduction Narrative interviews place the people being interviewed at the heart of a research study. They are a means of collecting people's own stories about their experiences of health and illness. Narrative interviews can help researchers to better understand people's experiences and behaviours. Narratives may come closer to representing the context and integrity of people's lives than more quantitative means of research. Methodology Researchers using narrative interview techniques do not set out with a fixed agenda, rather they tend to let the interviewee control the direction, content and pace of the interview. The paper describes the interview process and the suggested approach to analysis of narrative interviews, We draw on the example from a study that used series of narrative interviews about people's experiences of taking antidepressants. Limitations Some people may find it particularly challenging to tell their story to a researcher in this way rather than be asked a series of questions like in a television or radio interview. Narrative research like all qualitative research does not set out to be generalisable and may only involve a small set of interviews.

Increased Pathological Worry Levels in Patients with Alopecia Areata

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Basak Sahin

2017-01-01

Full Text Available Aim: Alopecia Areata (AA is a type of hair loss that has been considered to have associations with various psychiatric disorders. In this study, we aimed to compare pathological worry levels between patients with AA and healthy controls (HC. Material and Method: Sixty-three patients with AA and 90 HCs were included in the present study after applying inclusion and exclusion criteria. The socio-demographic characteristics, some clinical characteristics, and the scores from the Penn State Worry Questionnaire (PSWQ were compared between groups. Results: The demographic characteristics were found to be similar between groups except for gender. The family history of AA was significantly higher in the AA group. The mean score of PSWQ in the AA group was 44.02 ± 11.59, compared to 39.71 ± 7.77 in the HC group. The mean score of PSWQ was significantly higher in the AA group (t=-3.27, p= 0.001.Discussion: The present study is the first to compare pathological worry between patients with AA and HCs. We suggest that pathological worry should be more thoroughly investigated in patients with AA to improve their quality of life. Also, this can be an effective approach to targeting the patients who may develop anxiety disorder.

Teacher Narratives and Student Engagement: Testing Narrative Engagement Theory in Drug Prevention Education

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Miller-Day, Michelle; Hecht, Michael L.; Krieger, Janice L.; Pettigrew, Jonathan; Shin, YoungJu; Graham, John

2015-01-01

Testing narrative engagement theory, this study examines student engagement and teachers’ spontaneous narratives told in a narrative-based drug prevention curriculum. The study describes the extent to which teachers share their own narratives in a narrative-based curriculum, identifies dominant narrative elements, forms and functions, and assesses the relationships among teacher narratives, overall lesson narrative quality, and student engagement. One hundred videotaped lessons of the keepin’ it REAL drug prevention curriculum were coded and the results supported the claim that increased narrative quality of a prevention lesson would be associated with increased student engagement. The quality of narrativity, however, varied widely. Implications of these results for narrative-based prevention interventions and narrative pedagogy are discussed. PMID:26690668

A collaborative narrative inquiry: Two teacher educators learning about narrative inquiry

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Barkhuizen, Gary

2009-12-01

Full Text Available With its capacity to unharness the power of narrative to promote meaning-making of lived experience, narrative inquiry is developing as a credible approach to research in several areas in the field of language teaching (Johnson, 2006. This article tells the story of two narrative researchers working in language teacher education who engaged in a collaborative narrative inquiry as both participants and inquirers, in order to learn more about narrative inquiry. The ‘bounded’ nature of their inquiry design provided a feasible way for them to explore their focus of research (i.e. their learning about narrative inquiry, and led them, through an iterative and reflexive process of analysing their narrative data, to formulate what they believe are essential ingredients of principled narrative inquiry work. Four narrative inquiry variables became the scaffolding which enabled them to answer their research questions, and are offered here as a heuristic for teaching practitioners, whether they be teachers, teacher educators or researchers, to guide them in narrative inquiries into their own work.

Anti-inflammatory and immunomodulating properties of the herbal preparation indicated for prevention and treatment of alopecia

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Galkin AY

2013-10-01

Full Text Available Alexander Yu Galkin,1,2 Valentine F Solovjova,3 Alex M Dugan11Department of Industrial Biotechnology, Faculty of Biotechnology and Bioengineering, National Technical University of Ukraine "Kyiv Polytechnic Institute", Kyiv, Ukraine; 2Research and Development Department, PRO-PHARMA Company, LLC, Kyiv, Ukraine; 3Laboratory of Hygiene Expertise, Ukrainian Research Institute of Nutrition, Biotechnology and Pharmacy, Kyiv, UkraineBackground: Alopecia is a chronic inflammatory disease, in which the hair follicles become damaged. The etiology of the disease is still little known; the most common cause of alopecia is likely an autoimmune mechanism. Medicinal herbs (Arctium lappa roots, Sophora japonica fruits, Acorus calamus roots, Urtica dioica leaves, Humulus lupulus fruits are promising remedies for the prevention and treatment of alopecia.Methods: Anti-inflammatory properties of the phytopreparation were investigated using the following models: "rigid" inflammatory model and model of adrenalin pulmonary edema (anti-exudative activity, as well as the "cotton granuloma" model (influence on proliferative effects. Immunomodulatory properties were studied by analyzing the metabolic activity of macrophages exposed to herbal preparation as well as the secretion of monocyte-derived cytokines.Results: Intragastric administration of the herbal preparation reduced severity of the exudation phase of inflammation in the limbs of animals (37.3% and inhibited pulmonary edema (21.0%. It was demonstrated that the phytopreparation reduced the weight of the granulation-fibrous tissue by 50.6%. The phytopreparation activated macrophages (50–400 µg/mL, decreased the number of flattened cells, increased the number of rounded cells and increased the production of oxidative metabolites (by 26% compared with intact cells. The herbal drug (0–300 µg/mL increased cytokines secretion by human blood cells (interleukin-2 and interferon-γ.Conclusion: The phytopreparation

Reduced incidence of skin cancer in patients with alopecia areata: A retrospective cohort study.

Science.gov (United States)

Mostaghimi, Arash; Qureshi, Sarah; Joyce, Cara; Guo, Ye; Huang, Kathie P

2016-04-01

The risk of skin cancer in patients with alopecia areata (AA) is unknown. While the risk of skin cancer in chronic inflammatory alopecias may be elevated, AA shares many characteristics with vitiligo, an autoimmune illness associated with decreased risk of melanoma and non-melanoma skin cancers. In this retrospective cohort study, we determined the risk of developing skin cancer among patients with AA in a validated cohort relative to matched controls at two tertiary care hospitals in Massachusetts. There was a significantly decreased risk of NMSC in AA patients than controls (OR=0.63, 95% CI=0.48-0.81). There was a trend towards a protective effect of AA associated with melanoma (OR=0.65, 95% CI=0.39-1.09). There was no difference in anatomic distribution of skin cancer between patients with AA and controls. Our study demonstrates a decreased risk of nonmelanoma skin cancer and a trend towards reduced risk of melanoma in patients with AA. Copyright © 2016. Published by Elsevier Ltd.

Narrative approaches

DEFF Research Database (Denmark)

Stelter, Reinhard

2012-01-01

Narrative coaching is representative of the new wave – or third generation – of coaching practice . The theory and practice of narrative coaching takes into account the social and cultural conditions of late modern society, and must be seen as intertwined with them. Some initial conceptualizations...... of narrative coaching were developed by David Drake (2006, 2007, 2008, 2009) in the USA and Australia, by Ho Law in the UK (Law, 2007a + b; Law & Stelter, 2009) and by Reinhard Stelter (2007, 2009, 2012, in preparation; Stelter & Law, 2010) in Denmark. In the following chapter the aim is to present coaching...... as a narrative-collaborative practice, an approach that is based on phenomenology, social constructionism and narrative theory. Seeing narrative coaching as a collaborative practice also leads to reflecting on the relationship between coach and coachee(s) in a new way, where both parts contribute to the dialogue...

Nye narrative gleder?

DEFF Research Database (Denmark)

Bondebjerg, Ib

2008-01-01

Anmeldelse af Anne Mangen: New Narrative Pleasures? A Cognitive-Phenomenological Study of the Experience of Reading Digital Narrative Fictions.......Anmeldelse af Anne Mangen: New Narrative Pleasures? A Cognitive-Phenomenological Study of the Experience of Reading Digital Narrative Fictions....

Narratives of psychiatric malingering in works of fiction.

Science.gov (United States)

Kuperman, V

2006-12-01

This paper argues that the representation of psychiatric malingering in literary and cinematographic narratives informs societal stereotypes, and thus influences the clinical phenomenology of malingering. The study aims to identify sociocultural models of malingering in contemporary Western society based on the narrative analysis of about 60 fictional and non-fiction texts. Two behavioural patterns derived from the Foucauldian categories folly and madness are recognisable in naïve conceptualisations of fake insanity. Fabricated significations of deviation originate in grand societal narratives rather than in medical discourse, and construct characters such as animal like underdeveloped simpletons or detached, irrational, violent madmen. Each pattern stems from its own archaic conceptual basis and dictates a distinct framework for strategies of malingering. The semiotic structure of artistic narratives of malingering is discussed in comparison with the symptomatology of existing psychiatric models.

Narrative and embodiment

DEFF Research Database (Denmark)

Køster, Allan

2016-01-01

Recent work on the relation between narrative and selfhood has emphasized embodiment as an indispensable foundation for selfhood. This has occasioned an interesting debate on the relation between embodiment and narrative. In this paper, I attempt to mediate the range of conflicting intuitions......) strictly is or is not; rather, we need to see narrative as an attribute admitting of degrees. I suggest that the relation between narrative and embodiment should be seen along these lines, proposing three levels of the narrativity of embodied experiencing: 1) the unnarratable, 2) the narratable and 3...

Evaluation of DNA Variants Associated with Androgenetic Alopecia and Their Potential to Predict Male Pattern Baldness

DEFF Research Database (Denmark)

Marcińska, Magdalena; Pośpiech, Ewelina; Abidi, Sarah

2015-01-01

Androgenetic alopecia, known in men as male pattern baldness (MPB), is a very conspicuous condition that is particularly frequent among European men and thus contributes markedly to variation in physical appearance traits amongst Europeans. Recent studies have revealed multiple genes and polymorp......Androgenetic alopecia, known in men as male pattern baldness (MPB), is a very conspicuous condition that is particularly frequent among European men and thus contributes markedly to variation in physical appearance traits amongst Europeans. Recent studies have revealed multiple genes...... and an extended 20-SNP model were developed based on a discovery panel of 305 males from various European populations fitting one of two distinct phenotype categories. The first category consisted of men below 50 years of age with significant baldness and the second; men aged 50 years or older lacking baldness...

Animation with concurrent narration versus narration in physical education lesson

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Ioannou Panagiotis

2016-01-01

Full Text Available The purpose of the present study was to compare the effects of two different teaching methods on students' comprehension during Physical Education lesson: narration versus animation with concurrent narration, during teaching shot put event. Thirty primary school children (boys and girls volunteered to participate in this study. In experiment students listened (narration and viewed (animation with narration the presentation of two shot putting styles. A problem-solving and a retention test were used to evaluate students' comprehension. Results showed that students' comprehension was better when shot putting styles were presented through a mixed model (animation and narration group than a single (narration. The animation with concurrent narration group performed better than the narration group, in problem-solving (M = 4.91, SD = 1.36 and in retention test (M = 5.98, SD = 1.28 t(28 = 1.89 p<0.01. An instructional implication is that pictures with words is more effective way of teaching when they occur continuingly in time, than only words during Physical Education lesson.

Intermediate Uveitis and Alopecia Areata : Is There a Relationship? Report of 3 Pediatric Cases

NARCIS (Netherlands)

Ayuso, Viera Kalinina; Pott, Jan Willem; de Boer, Joke Helena

2011-01-01

Three previously healthy children, aged 5, 8, and 15 years, with idiopathic intermediate uveitis (IU) and alopecia areata (AA) are described. These are the first 3 cases of which we are aware with this coexistence. The results of extensive diagnostic evaluations were negative in all 3 cases. AA

Religious narrative

DEFF Research Database (Denmark)

Geertz, Armin W.

2013-01-01

Denne artikel er en introduktion til et temanummer i religionslærernes tidsskrift i USA. Den er et udtræk af mit kapitel "Religious Narrative, Cognition and Culture: Approaches and Definitions" udgivet i Religious Narrative, Cognition and Culture: Image and Word in the mind of Narrative, redigeret...

Study on the Related Teaching of "Narrative Creation" and "Narrative Reading" : Making use of "the method of narrative" as a common element

OpenAIRE

Mitoh, Yasuhiro

2014-01-01

This study has explored the related teaching of "narrative creation" and "narrative reading". For this study, I hypothesized as follows. There is "the method of narrative" in "narrative creation" and "narrative reading" as a common element. By this related teaching that used "the method of narrative" as a common element, children’s ability of "narrative creation" and "narrative reading" will increase. As a result of this study, the following conclusions were obtained. Children surely make use...

Evaluation of the profile of alopecia areata and the prevalence of thyroid function test abnormalities and serum autoantibodies in Iranian patients

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Mirpour Sahar

2005-10-01

Full Text Available Abstract Background The study aimed at evaluating the prevalence of thyroid function abnormalities in patients with alopecia areata (AA and its association with other autoimmune diseases and various autoimmune antibodies. Method We retrospectively analyzed medical records of 123 patients with AA. The main site of involvement, pattern, and extent of alopecia as well as presence of the similar disease in first-degree family members and serologic status of patients were recorded. Results Participating in the study were 57 males and 66 females (6 to 59 years old. In the majority of patients (69.9% the disease was manifested in the first two decades of life. Patients with family members having alopecia were recorded in 24.4%. Thyroid function abnormalities were found in 8.9% of patients. Positive autoimmune antibodies were associated with AA in 51.4% of patients with no significant association between the severity and duration of disease and presence of these antibodies. Conclusion The incidence of positive auto-immune antibodies in Iranian patients is higher than previous reports. Concerning the female:male ratio, thyroid function tests and the prevalence of alopecia in first-degree relatives, our results are compatible with previous data obtained from different ethnic populations. Previous reports documented that a greater severity and longer duration of AA were seen in the early onset forms; however our result are relatively different which could be explained by differences in genetic factors.

Models to enhance research capacity and capability in clinical nurses: a narrative review.

Science.gov (United States)

O'Byrne, Louise; Smith, Sheree

2011-05-01

To identify models used as local initiatives to build capability and capacity in clinical nurses. The National Health Service, Nursing and Midwifery Council and the United Kingdom Clinical Research Collaboration all support the development of the building of research capability and capacity in clinical nurses in the UK. Narrative review. A literature search of databases (including Medline and Pubmed) using the search terms nursing research, research capacity and research capability combined with building, development, model and collaboration. Publications which included a description or methodological study of a structured initiative to tackle research capacity and capability development in clinical nurses were selected. Three models were found to be dominant in the literature. These comprised evidence-based practice, facilitative and experiential learning models. Strong leadership, organisational need and support management were elements found in all three models. Methodological issues were evident and pertain to small sample sizes, inconsistent and poorly defined outcomes along with a lack of data. Whilst the vision of a research ready and active National Health Service is to be applauded to date, there appears to be limited research on the best approach to support local initiatives for nurses that build research capability and capacity. Future studies will need to focus on well-defined objectives and outcomes to enable robust evidence to support local initiatives. To build research capability and capacity in clinical nurses, there is a need to evaluate models and determine the best approach that will provide clinical nurses with research opportunities. © 2010 Blackwell Publishing Ltd.

Quality of life and maladjustment associated with hair loss in women with alopecia androgenetica

NARCIS (Netherlands)

J. van der Donk (J.); J.A.M. Hunfeld (Joke); J. Passchier (Jan); K.J. Knegt-Junk (K.); C. Nieboer (C.)

1994-01-01

textabstractQuality of life and maladjustment related to hair loss were studied by means of a standardized interview in a group of 58 women with alopecia androgenetica who applied for treatment at the Department of Dermatology. The hair loss was found to have a negative influence on the quality of

Visual narrative structure.

Science.gov (United States)

Cohn, Neil

2013-04-01

Narratives are an integral part of human expression. In the graphic form, they range from cave paintings to Egyptian hieroglyphics, from the Bayeux Tapestry to modern day comic books (Kunzle, 1973; McCloud, 1993). Yet not much research has addressed the structure and comprehension of narrative images, for example, how do people create meaning out of sequential images? This piece helps fill the gap by presenting a theory of Narrative Grammar. We describe the basic narrative categories and their relationship to a canonical narrative arc, followed by a discussion of complex structures that extend beyond the canonical schema. This demands that the canonical arc be reconsidered as a generative schema whereby any narrative category can be expanded into a node in a tree structure. Narrative "pacing" is interpreted as a reflection of various patterns of this embedding: conjunction, left-branching trees, center-embedded constituencies, and others. Following this, diagnostic methods are proposed for testing narrative categories and constituency. Finally, we outline the applicability of this theory beyond sequential images, such as to film and verbal discourse, and compare this theory with previous approaches to narrative and discourse. Copyright © 2012 Cognitive Science Society, Inc.

Androgenetic alopecia and risk of coronary artery disease

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Lata Sharma

2013-01-01

Full Text Available Background: Androgenetic alopecia (AGA or male pattern baldness (MPB has been found to be associated with the risk of coronary artery disease (CAD. The well-known risk factors are family history of CAD, hypertension, increased body mass index (BMI, central obesity, hyperglycemia, and dyslipidemia. The newer risk factors are serum lipoprotein-a (SL-a, serum homocysteine (SH, and serum adiponectin (SA. Aim : Identifying individuals at risk of CAD at an early age might help in preventing CAD and save life. Hence, a comparative study of CAD risk factors was planned in 100 males of AGA between the age of 25 and 40 years with equal number of age- and sex-matched controls. Materials and Methods : Patients of AGA grade II or more of Hamilton and Norwood (HN Scale and controls were examined clinically and advised blood test. The reports were available for fasting blood sugar (FBS, serum total serum cholesterol (SC in 64 cases, 64 controls; lipoproteins (high, low, very low density, HDL, LDL, VLDL, serum triglycerides (ST in 63 cases, 63 controls; SL-a in 63 cases, 74 controls; SH in 56 cases, 74 controls; and SA in 62 cases, 74 controls. Results : In these cases family history (FH of AGA and CAD was significantly high. The blood pressure (BP was also found to be significantly high in the cases. The difference of mean serum HDL, LDL, VLDL, ST, SH, and SL-a in cases and controls were statistically significant and with increasing grade of AGA, the risk factors also increased. Conclusion : Patients with AGA appear to be at an increased risk of developing CAD, therefore, clinical evaluation of cases with AGA of grade II and above may be of help in preventing CAD in future.

Uso da fluoxetina no tratamento da tricotilomania felina Use of fluoxetine in the treatment of feline psycogenic alopecia

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Marlos Gonçalves Sousa

2004-06-01

Full Text Available A tricotilomania ou alopecia psicogênica felina é uma dermatopatia de origem psicogênica, decorrente da lambedura compulsiva do pelame, realizada pelo gato em situações de estresse. Tal distúrbio decorre de alterações neuro-hormonais e pode associar-se à introdução de novos animais e/ou crianças no ambiente. Além de mudanças de manejo e atitude para com o animal, sugere-se o emprego de ansiolíticos no tratamento da doença. A fluoxetina foi utilizada no tratamento de cinco gatos domésticos com tricotilomania, apresentando inibição do comportamento de lambedura, com repilação após dois a três meses de terapia.Feline psycogenic alopecia occurs when cats lick their hair compulsively. Stress situations play a role in this disturbance, due to changes in neurohormone mechanisms. The introduction of a new animal or baby in the household can also be associated. Besides behavioral changes towards the animal, the use of anxiolytics is suggested to treat the disease. Fluoxetine was used in the treatment of 5 domestic cats with psycogenic alopecia, showing showing inhibition of licking attitude, with repilation within two to three months of use.

"Response to Comments": Finding the Narrative in Narrative Research

Science.gov (United States)

Coulter, Cathy A.

2009-01-01

The author responds to comments by Barone (2009), Clandinin and Murphy (2009), and M. W. Smith (2009) on "The Construction Zone: Literary Elements in Narrative Research" (Coulter & M. L. Smith, 2009). She clarifies issues regarding point of view, authorial surplus, narrative coherence, and the relational qualities of narrative research. She…

Automatic generation of nursing narratives from entity-attribute-value triplet for electronic nursing records system.

Science.gov (United States)

Min, Yul Ha; Park, Hyeoun-Ae; Lee, Joo Yun; Jo, Soo Jung; Jeon, Eunjoo; Byeon, Namsoo; Choi, Seung Yong; Chung, Eunja

2014-01-01

The aim of this study is to develop and evaluate a natural language generation system to populate nursing narratives using detailed clinical models. Semantic, contextual, and syntactical knowledges were extracted. A natural language generation system linking these knowledges was developed. The quality of generated nursing narratives was evaluated by the three nurse experts using a five-point rating scale. With 82 detailed clinical models, in total 66,888 nursing narratives in four different types of statement were generated. The mean scores for overall quality was 4.66, for content 4.60, for grammaticality 4.40, for writing style 4.13, and for correctness 4.60. The system developed in this study generated nursing narratives with different levels of granularity. The generated nursing narratives can improve semantic interoperability of nursing data documented in nursing records.

Follicular delivery of spironolactone via nanostructured lipid carriers for management of alopecia

OpenAIRE

Shamma, Rehab Nabil; Aburahma, Mona Hassan

2014-01-01

Rehab Nabil Shamma, Mona Hassan AburahmaDepartment of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, EgyptAbstract: Spironolactone (SL) is a US Food and Drug Administration-approved drug for the treatment of hypertension and various edematous conditions. SL has gained a lot of attention for treating androgenic alopecia due to its potent antiandrogenic properties. Recently, there has been growing interest for follicular targeting of drug molecules...

Narrative means to manage responsibility in life narratives across adolescence.

Science.gov (United States)

De Silveira, Cybèle; Habermas, Tilmann

2011-01-01

Adolescence is a passage from dependence to adult responsibility. Alongside identity development, social-cognitive development, and the ability to construct a life story, adolescents become increasingly aware of both their potential responsibility in an expanded sphere of life and of complex, contextual influences on their lives. This was partially tested in a cross-sectional study, both in terms of linguistic means and content expressed in life narratives. Indicators were defined for narrative agency, grading of responsibility, serendipity, and turning points, and tested for age differences in relative frequencies in 102 life narratives from age groups of 8, 12, 16, and 20 years, balanced for gender. Narrative grading of responsibility, serendipity, and turning points increased throughout adolescence. The relative frequency of narrative agency, in contrast, remained constant across age groups. Results are interpreted in the context of adolescent development of narrative identity.

Narrative udvidelser

DEFF Research Database (Denmark)

Skøtt, Bo

2015-01-01

Dette pilotstudies ambition er at undersøge, hvordan og hvorfor narrative elementer lejlighedsvist aktiveres af aktører i deres kontakt med bibliotekarer i folkebiblioteker. Ved hjælp af en kulturanalytisk tilgang studeres forskellige aktørers narrative udvidelser af referenceinterviewet. Teoretisk....... Pilotstudiet bekræfter de 2 indledende antagelser: 1) at nogle aktører anvender narrative udvidelser, fordi de vælger at betone den mellemmenneskelige relation mellem aktør og bibliotekar, som om det var enhver anden social relation og derved ignorerer andre, mere repræsentative dele af bibliotekarernes...... funktioner. Og 2) at nogle aktører anvender narrative udvidelser i bestræbelserne på at legitimere egne sociale positioner og identitetsdannelse gennem kritisk refleksion over bibliotekarernes og folkebibliotekets institutionelle position og magt. Gennem den narrative udvidelse formår disse aktører...

Factors Influencing the Effectiveness of Scalp Cooling in the Prevention of Chemotherapy-Induced Alopecia

OpenAIRE

Komen, Manon M.C.; Smorenburg, Carolien H.; van den Hurk, Corina J.G.; Nortier, Johan W.R.

2013-01-01

The success of scalp cooling in preventing or reducing chemotherapy-induced alopecia (CIA) is highly variable. In a review of the literature, this study found that the factors influencing the effectiveness of scalp cooling to prevent CIA in patients with cancer include chemotherapy type and dose, as well as the degree and duration of cooling.

Who speaks? Who looks? Who feels? Point of view in autobiographical narratives.

Science.gov (United States)

Habermas, Tilmann

2006-04-01

In this paper, the author aims to substantiate Freud's claim that neurotic illness creates gaps in autobiographical narratives in terms of the narrator's stating and inducing perspectives. He sketches out the role of narrative perspective and the joint taking of a shared perspective by analyst and patient in psychoanalytic therapy. He introduces four ways of representing perspectives in narratives. Three degrees of narrative distortion are exemplified by three excerpts from life narratives and explored in terms of narrative perspective representation. The most comprehensive perspective representation is achieved in the first example by explicitly stating the present perspective of the narrator as well as the past perspective of the story's protagonist by use of mental verbs. In the second narrative, exclusive use of linguistic forms for inducing the protagonist's perspective both overwhelms the narrator and gives the listener an incomplete picture of what happened. Inconsistent motives, denial of responsibility and omission of detail render the third narrative even more difficult to follow. The author discusses the clinical significance of this exploratory analysis of perspectives in narratives in terms of claiming responsibility for one's past action and of level of defence mechanisms, and by highlighting the emotional impact on listeners, which the author suggests is the stronger the more perspectives are left out. He discusses analogies to countertransference. The analysis of narrative perspectives offers an approach for systematic research in psychoanalytic practice.

Iontophoresis-targeted, follicular delivery of minoxidil sulfate for the treatment of alopecia.

Science.gov (United States)

Gelfuso, Guilherme Martins; Gratieri, Tais; Delgado-Charro, M Begoña; Guy, Richard H; Vianna Lopez, Renata Fonseca

2013-05-01

Although minoxidil (MX) is a drug known to stimulate hair growth, the treatment of androgenic alopecia could be improved by delivery strategies that would favor drug accumulation into the hair follicles. This work investigated in vitro the potential of iontophoresis to achieve this objective using MX sulfate (MXS), a more water-soluble derivative of MX. Passive delivery of MXS was first determined from an ethanol-water solution and from a thermosensitive gel. The latter formulation resulted in greater accumulation of MXS in the stratum corneum (skin's outermost layer) and hair follicles and an overall decrease in absorption through the skin. Anodal iontophoresis of MXS from the same gel formulation was then investigated at pH 3.5 and pH 5.5. Compared with passive delivery, iontophoresis increased the amount of drug reaching the follicular infundibula from 120 to 600 ng per follicle. In addition, drug recovery from follicular casts was threefold higher following iontophoresis at pH 5.5 compared with that at pH 3.5. Preliminary in vivo experiments in rats confirmed that iontophoretic delivery of MXS facilitated drug accumulation in hair follicles. Overall, therefore, iontophoresis successfully and significantly enhanced follicular delivery of MX suggesting a useful opportunity for the improved treatment of alopecia. Copyright © 2013 Wiley Periodicals, Inc.

Follicular delivery of spironolactone via nanostructured lipid carriers for management of alopecia.

Science.gov (United States)

Shamma, Rehab Nabil; Aburahma, Mona Hassan

2014-01-01

Spironolactone (SL) is a US Food and Drug Administration-approved drug for the treatment of hypertension and various edematous conditions. SL has gained a lot of attention for treating androgenic alopecia due to its potent antiandrogenic properties. Recently, there has been growing interest for follicular targeting of drug molecules for treatment of hair and scalp disorders using nanocolloidal lipid-based delivery systems to minimize unnecessary systemic side effects associated with oral drug administration. Accordingly, the objective of this study is to improve SL efficiency and safety in treating alopecia through the preparation of colloidal nanostructured lipid carriers (NLCs) for follicular drug delivery. SL-loaded NLCs were prepared by an emulsion solvent diffusion and evaporation method using 23 full factorial design. All of the prepared formulations were spherical in shape with nanometric size range (215.6-834.3 nm) and entrapment efficiency >74%. Differential scanning calorimetry thermograms and X-ray diffractograms revealed that SL exists in amorphous form within the NLC matrices. The drug release behavior from the NLCs displayed an initial burst release phase followed by sustained release of SL. Confocal laser scanning microscopy confirmed the potential of delivering the fluorolabeled NLCs within the follicles, suggesting the possibility of using SL-loaded NLCs for localized delivery of SL into the scalp hair follicles.

Quantitative Analysis Using the Phototrichogram Technique of an Italian Population Suffering from Androgenic Alopecia

Directory of Open Access Journals (Sweden)

Sara Brancato

2018-04-01

Full Text Available In this study, the values of some scalp basal parameters, collected during several clinical studies involving a total of 254 subjects with androgenic alopecia, were analyzed. Subjects’ values were grouped by age and gender, and the differences between groups were examined. The density values (n° of hair/cm2 and the percentages of anagen and telogen hair were considered. Furthermore, the variations recorded at the end of cosmetic treatments (ranging from 12 to 16 weeks aiming to reduce excessive hair loss were analyzed. The basal values regarding the percentage of hair in the anagen phase evidenced a linear decrease with increasing age, with a corresponding increase of the percentage of hair in the telogen phase. As far as the hair density differences between males and females are concerned, females had a mean value significantly higher than males. Moreover, at the end of the intended anti-hair loss treatments, females were more susceptible to improvements of their hair density values.

Narrative teorier

DEFF Research Database (Denmark)

Bank, Mads

2014-01-01

kapitlet omhandler Narrative psykologiske teorier i et personlighedspsykologisk og socio-kulturelt perspektiv.......kapitlet omhandler Narrative psykologiske teorier i et personlighedspsykologisk og socio-kulturelt perspektiv....

Formulate, Formalize and Run! How Narrative Theories shape and are shaped by Interactive Digital Narrative

OpenAIRE

Szilas, Nicolas

2016-01-01

What are the links between narrative theories and computing? Narrative works are countless in the digital world: narrative hypertext and hypermedia, interactive fiction, video games, blogs, location-based narrative, etc. They not only form new analytical objects for narrative theories, but also may extend existing narrative theories. One specific type of digital narratives, AI-based Interactive Digital Narrative (IDN), plays a special role in this landscape because it makes use of narrative t...

Why might you use narrative methodology? A story about narrative

Directory of Open Access Journals (Sweden)

Lynn McAlpine

2016-04-01

Full Text Available Narrative is one of many qualitative methodologies that can be brought to bear in collecting and analysing data and reporting results, though it is not as frequently used as say in case studies. This article provides a window into its use, from the perspective of a researcher who has used it consistently over the past decade to examine early career researcher experience – doctoral students, and those who have completed their degrees and are advancing their careers. This experience has contributed to a robust understanding of the potential of narrative, as well as its limitations. This paper first lays out the broad landscape of narrative research and then makes transparent the thinking, processes and procedures involved in the ten-year narrative study including the potential for creativity that narrative invites. The goal is to engage other researchers to consider exploring the use of narrative – if it aligns with their epistemological stance.

The form of the story: Measuring formal aspects of narrative activity in psychotherapy.

Science.gov (United States)

Habermas, Tilmann; Döll-Hentschker, Susanne

2017-05-01

We ask which are the clinically relevant qualities of narratives in psychotherapy and how they can be measured. On the background of psychoanalytic assumptions and narrative theory, we propose to measure formal narrative processes which stay close to the linguistic surface, because these escape conscious control. We propose five aspects of narratives to be especially sensitive to distortions and therefore prone to change in successful therapies: (1) The actual chronological, stepwise narrating of events, (2) the intentional structuring of events, or emplotment, (3) the immediate evaluation, (4) the reflected interpretation of events, and finally (5) the consistency and completeness of the narrative. For each aspect we discuss ways to measure them. Finally the aspects are illustrated with excerpts from a series of diagnostic interviews. Implications for the analysis of the co-narrative role of the therapist are suggested.

Self-defining memories, scripts, and the life story: narrative identity in personality and psychotherapy.

Science.gov (United States)

Singer, Jefferson A; Blagov, Pavel; Berry, Meredith; Oost, Kathryn M

2013-12-01

An integrative model of narrative identity builds on a dual memory system that draws on episodic memory and a long-term self to generate autobiographical memories. Autobiographical memories related to critical goals in a lifetime period lead to life-story memories, which in turn become self-defining memories when linked to an individual's enduring concerns. Self-defining memories that share repetitive emotion-outcome sequences yield narrative scripts, abstracted templates that filter cognitive-affective processing. The life story is the individual's overarching narrative that provides unity and purpose over the life course. Healthy narrative identity combines memory specificity with adaptive meaning-making to achieve insight and well-being, as demonstrated through a literature review of personality and clinical research, as well as new findings from our own research program. A clinical case study drawing on this narrative identity model is also presented with implications for treatment and research. © 2012 Wiley Periodicals, Inc.

Losing the Plot: Narrative, Counter-Narrative and Violent Extremism

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Andrew Glazzard

2017-05-01

Full Text Available Counter-terrorist practitioners and policy makers appear to be very interested in narrative. They often describe the worldview of violent Islamist groups and movements as the ‘jihadi narrative’, while their efforts to confront terrorist propaganda are usually labelled as ‘counter-narrative’ or ‘alternative narrative’. However, while the counter-narrative approach has gained widespread acceptance in governments, think-tanks and civil society organisations, it is built on very shaky theoretical and empirical foundations. Some valuable theoretical contributions to the study of violent extremist narrative have been made by psychologists in particular, but there is one discipline which is conspicuous by its absence from the field: literary studies. This paper makes a case for the value of studying violent extremist narratives as narratives in the literary sense. By employing the tools and techniques of literary criticism, violent extremist communication can be revealed as not only potentially persuasive, but also creative and aesthetically appealing: terrorists inspire their followers, they don’t merely persuade them. Understanding the creative sources of this inspiration is vital if counter-narrative is to succeed in presenting an alternative to the propaganda of violent extremist groups.

Listening with a narrative ear: Insights from a study of fall stories in older adults.

Science.gov (United States)

Pereles, Laurie; Jackson, Roberta; Rosenal, Tom; Nixon, Lara

2017-01-01

To determine the value of adding a patient narrative to the clinical assessment of falls in the elderly. Qualitative study of interviews. A fall prevention clinic in Calgary, Alta. Fifteen older adults on a wait list for assessment by the fall clinic and the physiotherapists who assessed them. Participants' stories were audiorecorded and later transcribed and summarized. Stories were collected using open-ended questions, first inviting participants to tell the interviewer about themselves, and then the circumstances of their falls and their reflections on them. In a subsequent visit, transcriptions or summaries were returned to patients for member checking. Narratives were read and analyzed by all 4 investigators using a narrative approach and a close-reading technique. With the patients' additional consent, stories were shared with the fall prevention team for their insights and reactions. Interviews with physiotherapists were audiorecorded and transcribed. The narrative analysis provided new insights into the attitudes about and perceptions of the causes of falls, their effects, and rehabilitation. Close reading exposed presentation of self, locus of control, and underlying social and emotional issues. The addition of patient narratives to clinical assessments offers clinicians an understanding of patients' perspectives, which can be used to better engage patients in rehabilitation. Copyright© the College of Family Physicians of Canada.

Importance of Group Therapeutic Support for Family Members of Children with Alopecia Areata: A Cross-Sectional Survey Study.

Science.gov (United States)

Aschenbeck, Kelly A; McFarland, Sarah L; Hordinsky, Maria K; Lindgren, Bruce R; Farah, Ronda S

2017-07-01

The psychological effect of alopecia areata (AA) is well documented, but group interaction may help lessen this burden. We aimed to determine factors that draw patients with AA and their families to group events. Surveys were administered at the annual alopecia areata bowling social in 2015 and 2016. This event is a unique opportunity for children with AA and their families to meet others with the disease and connect with local support group resources from the Minnesota branch of the National Alopecia Areata Foundation. Data from 2015 and 2016 were combined. Comparisons of subgroups were performed using Fisher exact tests for response frequencies and percentages and two-sample t tests for mean values. An equal number of men and women participated in the study (n = 13 each). The average age was 41.1 years. There were no significant differences (p > 0.05) in survey responses based on respondent age or sex. Twenty-three (88.5%) attendees sought to connect with others with AA and met three or more people during the event. Seventeen (65.4%) also attended other support group events. Twelve respondents (46.2%) came to support a friend or family member. One hundred percent of attendees identified socializing with others with AA as important. Group interaction is an important source of therapeutic support for people with AA and their families. © 2017 Wiley Periodicals, Inc.

Scalp cooling to prevent alopecia after chemotherapy can be considered safe in patients with breast cancer

NARCIS (Netherlands)

van den Hurk, C.J.; van de Poll-Franse, L.V.; Breed, W.P.M.; Coebergh, J.W.W.; Nortier, J.

2013-01-01

With modern scalp cooling equipment cytotoxic damage of hair root cells can be prevented in half of the patients with cancer at high risk of alopecia. However, traditionally doubt has existed whether scalp cooling might facilitate hiding and disseminating scalp skin metastases and thus decrease

Ectodermal dysplasia with alopecia, onychodysplasia, hypohidrosis, keratoderma, abnormal teeth and deafness

Directory of Open Access Journals (Sweden)

Akhyani Maryam

2007-01-01

Full Text Available The ectodermal dysplasias are a heterogeneous group of disorders with primary defect in hair, teeth, nail and sweat gland function. Numerous types have been described and several classifications exist. Here, we present a patient with ectodermal dysplasia with alopecia, dysplastic nails, hypohidrosis, sensorineural deafness, palmoplantar keratoderma, abnormal teeth and dry skin. To our knowledge, combination of all these features in ectodermal dysplasia has not been reported in the past. The etiology is unknown, but consanguinity of parents points to an autosomal recessive inheritance.

Narrative and Institutional Economics

Directory of Open Access Journals (Sweden)

Vyacheslav V. Volchik

2017-12-01

Full Text Available This article addresses a range of questions associated with the occurrence of a new field of study – narrative economics, which is considered in the context of modern institutionalism. Pioneering works of R. Shiller, G. Akerlof and D. Snower spotlighted the importance of analyzing narratives and narrative influence when studying economic processes. In this paper, a qualitative study of narratives is seen through the prism of an answer to the question: «How do prescribed narratives influence institutions and change them? ». Narratives have much in common with institutions since very often, explicitly or implicitly, they contain value judgements about social interactions or normative aspects shaping behavioral patterns. The identification of dominating narratives enables us to understand better how institutions influence economic (social action. Repeated interactions among social actors are structured through understanding and learning the rules. Understanding of social rules comes from the language – we articulate and perceive the rules drawing on common narratives. Narratives and institutions are helpful when actors gain knowledge about various forms of social communication. Digital technologies, mass media and social networking sites facilitate the spread of narratives, values and beliefs; this process is characterized by increasing returns. Studying narratives and institutions is crucial for modern economic theory because it helps to improve qualitative and quantitative methods of analyzing empirical evidence and enables researchers to understand complex economic processes.

Narrative Based Medicine and Neonatology: an interpretative approach

Directory of Open Access Journals (Sweden)

Massimiliano Zonza

2012-10-01

Full Text Available The use of Evidence Based Medicine (EBM has progressively lead doctors to focus their practice on the disease and not on the patient anymore. They consider a sick body or a sick part rather than a sick person. Such an attitude results in a progressive process of alienation or “unauthentic experience”. On the contrary the Medical Humanities represents a strong reaction to this state of things, and for Medicine a chance to embrace again its humanistic “vocation”. Narrative Based Medicine (NBM places at the center of the clinical practice the communicative and relational dimension. This study deepen the application of NBM to the scope of neonatal care. As a result of our work, we have identified in the NBM applied to the neonatal area a fundamental characteristic, the Neonatal Triangle (doctors, patient, parents, and a triple functionality (diagnostic, ethical and educational placed in three different ideal chronological moments (before, during and after. We explore the close connection between these functions and the clinical work and how the NBM model, through these same functions, enhance the opportunity of care and relationship. The main assumption is obviously the Doctors ability to build a shared narrative relation with the Parents of the little Patients, that in the technical terms of the Narrative Based Medicine is called co-construction of the illness history. We can remark that with the NBM we understand (the narrative frame, build (the therapeutic alliance and share (decisions.

Repeated monthly epicutaneous challenges with diphenylcyclopropenone result in a clinically reproducible level of contact allergy in de novo sensitized individuals

DEFF Research Database (Denmark)

Mose, K. F.; Andersen, F.; Skov, L

2017-01-01

Diphenylcyclopropenone (DPCP) has been used as an experimental contact allergen in humans and for topical immunotherapy of patients with alopecia areata. However, the efficacy is mostly based on case series. Randomized controlled clinical trials are lacking(1) , as is detailed descriptions of how...... repeated topical exposure to DPCP affect the level of hypersensitivity. This article is protected by copyright. All rights reserved.......Diphenylcyclopropenone (DPCP) has been used as an experimental contact allergen in humans and for topical immunotherapy of patients with alopecia areata. However, the efficacy is mostly based on case series. Randomized controlled clinical trials are lacking(1) , as is detailed descriptions of how...

THE ROLE OF ESTROGEN IN WOMEN WITH ANDROGENETIC ALOPECIA

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Putu Diah Pratiwi

2013-07-01

Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Hair loss may accured in both male and female population. Hair loss usually accured in Telogenic phase, meanwhile in Anagenic phase hair loss due to chemotherapy or radiation. Female pattern hair loss (FPHL is regarded as hair fall type which is accured in women in common and known as female androgenetic alopecia. Almost 40%, 50 years old female shown hair fall sign, which is developed progressive fibrosing alopecia of central scalp, especially in frontal and parietal area. There are two common treatment for Female pattern Hair Loss are Minoxidil for topical use, and Fenesteride by oral. However, it has long been known that estrogens also profoundly alter hair follicle growth and cycling by binding to locally expressed high-affinity estrogen receptors (ERs, in turn increase anagenic phase and represed telogenic phase. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

Efficacy of a cosmetic phyto-caffeine shampoo in female androgenetic alopecia.

Science.gov (United States)

Bussoletti, Carolina; Tolaini, Maria V; Celleno, Leonardo

2018-03-06

Androgenetic alopecia (AGA) is the most common type of hair loss in both males as well as females, occurring in up to 57% of women by the age of 80 years. Androgenetic alopecia is associated with a high psychological burden and often results in substantially reduced quality of life, poor body image and low self-esteem, particularly in women. Caffeine-based products have shown promise, both in vitro and in vivo, as potential treatments for AGA. This study was performed to determine the efficacy of a phyto-caffeine- containing shampoo used over a 6-month period in female subjects with AGA. This was a single-centre, double-blind parallel trial in which female subjects with AGA were randomized to either a phyto-caffeine-containing shampoo or a control shampoo. The primary endpoint was the change from baseline in the number of hairs pulled in a hair pull test at 6 months. Hair loss intensity, hair strength, subject satisfaction and tolerability were also assessed. Subjects using the phyto-caffeine-containing shampoo had significantly fewer hairs pulled in a hair pull test at 6 months, compared with subjects using the control shampoo (-3.1 vs -0.5 hairs; pshampoo, compared with controls. Both products were very well tolerated. Compared with a control shampoo, a phyto-caffeine-containing shampoo was more efficacious, with respect to the number of hairs being pulled out at 6 months, hair loss intensity and hair strength in subjects with AGA.

The Narrative-Emotion Process Coding System 2.0: A multi-methodological approach to identifying and assessing narrative-emotion process markers in psychotherapy.

Science.gov (United States)

Angus, Lynne E; Boritz, Tali; Bryntwick, Emily; Carpenter, Naomi; Macaulay, Christianne; Khattra, Jasmine

2017-05-01

Recent studies suggest that it is not simply the expression of emotion or emotional arousal in session that is important, but rather it is the reflective processing of emergent, adaptive emotions, arising in the context of personal storytelling and/or Emotion-Focused Therapy (EFT) interventions, that is associated with change. To enhance narrative-emotion integration specifically in EFT, Angus and Greenberg originally identified a set of eight clinically derived narrative-emotion integration markers were originally identified for the implementation of process-guiding therapeutic responses. Further evaluation and testing by the Angus Narrative-Emotion Marker Lab resulted in the identification of 10 empirically validated Narrative-Emotion Process (N-EP) markers that are included in the Narrative-Emotion Process Coding System Version 2.0 (NEPCS 2.0). Based on empirical research findings, individual markers are clustered into Problem (e.g., stuckness in repetitive story patterns, over-controlled or dysregulated emotion, lack of reflectivity), Transition (e.g., reflective, access to adaptive emotions and new emotional plotlines, heightened narrative and emotion integration), and Change (e.g., new story outcomes and self-narrative discovery, and co-construction and re-conceptualization) subgroups. To date, research using the NEPCS 2.0 has investigated the proportion and pattern of narrative-emotion markers in Emotion-Focused, Client-Centered, and Cognitive Therapy for Major Depression, Motivational Interviewing plus Cognitive Behavioral Therapy for Generalized Anxiety Disorder, and EFT for Complex Trauma. Results have consistently identified significantly higher proportions of N-EP Transition and Change markers, and productive shifts, in mid- and late phase sessions, for clients who achieved recovery by treatment termination. Recovery is consistently associated with client storytelling that is emotionally engaged, reflective, and evidencing new story outcomes and self-narrative

How can placebo effects best be applied in clinical practice? A narrative review

Directory of Open Access Journals (Sweden)

Bystad M

2015-01-01

Full Text Available Martin Bystad,1,2 Camilla Bystad,3 Rolf Wynn1,3 1Division of Addictions and Specialized Psychiatric Services, University Hospital of North Norway, 2Institute of Psychology, 3Institute of Clinical Medicine, Faculty of Health Sciences, Arctic University of Norway, Tromsø, Norway Abstract: Placebo effects are documented in a number of clinical and experimental studies. It is possible to benefit from placebo effects in clinical practice by using them as effects additive to those of documented and effective treatments. The purpose of this paper is to discuss how doctors and other health workers may benefit from placebo effects within an ethical framework. A narrative review of the literature relating to placebo effects in clinical practice was performed. We searched PubMed and selected textbooks on placebo effects for articles and book chapters relating to placebo effects in clinical practice. By drawing on placebo effects, doctors may access patients’ self-healing potentials. In practice, doctors may best benefit from placebo effects by influencing the patient’s expectations through communication. An important principle is to give the patient information stating that a particular treatment is effective, as long as this is based on realistic optimism. A patient-centered style involving elements such as developing trust and respect, exploring the patient’s values, speaking positively about treatments, and providing reassurance and encouragement might aid in activating placebo effects. The total effect of a documented treatment will partly depend on how well the placebo effects have been activated. Thus, placebo effects can be understood as a form of supplemental treatment. Keywords: placebo effects, doctor-patient communication, expectations, biopsychosocial model

Listeners as co-narrators.

Science.gov (United States)

Bavelas, J B; Coates, L; Johnson, T

2000-12-01

A collaborative theory of narrative story-telling was tested in two experiments that examined what listeners do and their effect on the narrator. In 63 unacquainted dyads (81 women and 45 men), a narrator told his or her own close-call story. The listeners made 2 different kinds of listener responses: Generic responses included nodding and vocalizations such as "mhm." Specific responses, such as wincing or exclaiming, were tightly connected to (and served to illustrate) what the narrator was saying at the moment. In experimental conditions that distracted listeners from the narrative content, listeners made fewer responses, especially specific ones, and the narrators also told their stories significantly less well, particularly at what should have been the dramatic ending. Thus, listeners were co-narrators both through their own specific responses, which helped illustrate the story, and in their apparent effect on the narrator's performance. The results demonstrate the importance of moment-by-moment collaboration in face-to-face dialogue.

Visuospatial Working Memory Capacity Predicts Physiological Arousal in a Narrative Task.

Science.gov (United States)

Smithson, Lisa; Nicoladis, Elena

2016-06-01

Physiological arousal that occurs during narrative production is thought to reflect emotional processing and cognitive effort (Bar-Haim et al. in Dev Psychobiol 44:238-249, 2004). The purpose of this study was to determine whether individual differences in visuospatial working memory and/or verbal working memory capacity predict physiological arousal in a narrative task. Visuospatial working memory was a significant predictor of skin conductance level (SCL); verbal working memory was not. When visuospatial working memory interference was imposed, visuospatial working memory was no longer a significant predictor of SCL. Visuospatial interference also resulted in a significant reduction in SCL. Furthermore, listener ratings of narrative quality were contingent upon the visuospatial working memory resources of the narrator. Potential implications for educators and clinical practitioners are discussed.

Whose Hearts and Minds? Narratives and Counter-Narratives of Salafi Jihadism

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Dina Al Raffie

2012-09-01

Full Text Available Since the advent of the Global War on Terror, the world has witnessed the continuation of terrorist activity under the banner of Salafi Jihad. With military action proving insufficient to defeat the propagators of the ideology, attention has turned to the ideology itself. Understanding the narratives that constitute this ideology and the systems in place that help propagate it is crucial to defeating it. Analysis brings to light elements that arguably constitute a Jihadist master narrative as well as support structures that help perpetuate key underlying messages of this master narrative. Successful counter-narratives should focus on rolling back and containing Jihadist narratives whilst simultaneously highlighting the values and attitudes of democratic, free societies

Modeling Narrative Discourse

Science.gov (United States)

Elson, David K.

2012-01-01

This thesis describes new approaches to the formal modeling of narrative discourse. Although narratives of all kinds are ubiquitous in daily life, contemporary text processing techniques typically do not leverage the aspects that separate narrative from expository discourse. We describe two approaches to the problem. The first approach considers…

Efficacy of topical latanoprost versus minoxidil and betamethasone valerate on the treatment of alopecia areata.

Science.gov (United States)

El-Ashmawy, Amal Ahmad; El-Maadawy, Iman Hamed; El-Maghraby, Gamal Mohamed

2018-02-01

Alopecia areata (AA) is one of the most common causes of localized hair loss. There is no universally proven therapy that induces and sustains remission of hair growth in AA. To compare the efficacy and safety of topical latanoprost, minoxidil and betamethasone valerate on hair growth in patients with AA. Hundred patients with AA classified into five groups of 20 treated with: Group I, latanoprost 0.1% lotion; Group II, minoxidil 5% lotion; Group III, betamethasone valerate 0.1% solution; Group IV, combination of latanoprost lotion and betamethasone valerate solution and Group V, a vehicle lotion control group. There was a statistically significant improvement in all therapeutic groups when compared with control group and reduction of severity of alopecia tool score of scalp and beard before and after treatment for all therapeutic groups. Latanoprost, minoxidil and betamethasone valerate are effective and safe in the treatment of patchy AA. The use of latanoprost added to the therapeutic efficacy of topical betamethasone valerate in the treatment of AA and could be an effective adjunctive topical therapy for AA.

Narrative serious game mechanics (NSGM) - insights into the narrative-pedagogical mechanism

NARCIS (Netherlands)

Lim, T.; Louchart, S.; Suttie, N.; Baalsrud Hauge, J.; Stanescu, I.A.; Ortiz, I.M.; Moreno-Ger, P.; Bellotti, F.; Brandao Carvalho, M.; Earp, J.; Ott, M.; Arnab, S.; Berta, R.; Göbel, S.; Wiemeyer, J.

2014-01-01

Narratives are used to construct and deconstruct the time and space of events. In games, as in real life, narratives add layers of meaning and engage players by enhancing or clarifying content. From an educational perspective, narratives are a semiotic conduit for evoking critical thinking skills

Empathic Communications and Narrative Competence in Contemporary Medical Education

Directory of Open Access Journals (Sweden)

Lindsay Holmgren

2016-12-01

Full Text Available Lindsay Holmgren’s “Empathic Communications and Narrative Competence in Contemporary Medical Education” reviews the teaching of narrative competency in medical education, arguing that these practices must engage postclassical approaches to narrative studies while attending to the concept of empathy as it is deployed in various disciplines, including narratology, cognitive science, and psychology. With an emphasis on the formation of professional identity in medical practice, Holmgren explores the relationship between professional identity in a multi-ethnic, gender-neutral, demographically and culturally diverse medical education context, and the complex arena of narrative empathy. Hinging her argument on the reciprocal nature of identity that emerges at the intersections of various versions of the self and others, Holmgren’s article aligns the empathy developed by reading fiction with that which develops in the clinical encounter. Finally, the article understands these various, evolving subject positions rhetorically, arguing that the comportments of medical educators in the humanities should be such that their students will want to emulate them.

Genome-wide meta-analysis in alopecia areata resolves HLA associations and reveals two new susceptibility loci

NARCIS (Netherlands)

Betz, Regina C; Petukhova, Lynn; Ripke, Stephan; Huang, Hailiang; Menelaou, Androniki; Redler, Silke; Becker, Tim; Heilmann, Stefanie; Yamany, Tarek; Duvic, Madeliene; Hordinsky, Maria; Norris, David; Price, Vera H; Mackay-Wiggan, Julian; de Jong, Annemieke; DeStefano, Gina M; Moebus, Susanne; Böhm, Markus; Blume-Peytavi, Ulrike; Wolff, Hans; Lutz, Gerhard; Kruse, Roland; Bian, Li; Amos, Christopher I; Lee, Annette; Gregersen, Peter K; Blaumeiser, Bettina; Altshuler, David; Clynes, Raphael; de Bakker, Paul I W; Nöthen, Markus M; Daly, Mark J; Christiano, Angela M

2015-01-01

Alopecia areata (AA) is a prevalent autoimmune disease with 10 known susceptibility loci. Here we perform the first meta-analysis of research on AA by combining data from two genome-wide association studies (GWAS), and replication with supplemented ImmunoChip data for a total of 3,253 cases and

Androgenic alopecia is not useful as an indicator of men at high risk of prostate cancer.

NARCIS (Netherlands)

Cremers, R.G.H.M.; Aben, K.K.H.; Vermeulen, S.; Heijer, M. den; Oort, I.M. van; Kiemeney, L.A.L.M.

2010-01-01

BACKGROUND: Androgens are assumed to play a central role in the pathophysiology of both prostate cancer (PC) and androgenic alopecia (AA). A correlation between the two phenotypes may be relevant for identification of men at high risk of PC. We evaluated the association between AA at different ages

Scalp cooling successfully prevents alopecia in breast cancer patients undergoing anthracycline/taxane-based chemotherapy.

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Vasconcelos, Ines; Wiesske, Alexandra; Schoenegg, Winfried

2018-04-13

Chemotherapy for breast cancer induces alopecia, representing a major source of patient distress. This study assesses whether a scalp-cooling device is effective in reducing chemotherapy-induced alopecia, and assesses adverse treatment effects. A prospective observational study including women with breast cancer undergoing chemotherapy and scalp cooling using a Paxman device. The primary efficacy end points were: successful hair preservation (no hair loss; <30% hair loss not requiring a wig; or <50% hair loss not requiring a wig) at the completion of chemotherapy. Secondary end points included adverse effects such as headache, pain, nausea or dizziness. The study enrolled 131 participants. Mean patient age was 49.8 years; 74% received anthracycline/taxane-based chemotherapy and 26% received taxane-monotherapy based chemotherapy. Hair preservation was successful in 102 women who underwent scalp cooling (71.0%; 95% CI = 63-79%). Only adverse events related to device use were collected, representing 7% (95% CI = 3-11%) of cases. Scalp cooling is effective in preventing hair loss among breast cancer patients undergoing standard chemotherapy treatment, and has minimal adverse effects. Copyright © 2018. Published by Elsevier Ltd.

Narrative Intervention for Children With Autism Spectrum Disorder (ASD).

Science.gov (United States)

Gillam, Sandra Laing; Hartzheim, Daphne; Studenka, Breanna; Simonsmeier, Vicki; Gillam, Ronald

2015-06-01

This study was conducted to determine whether a narrative intervention program that targeted the use of mental state and causal language resulted in positive gains in narrative production for children with autism spectrum disorder (ASD). Five children (2 girls and 3 boys) who had been diagnosed with ASD participated in the study. Children ranged in age from 8 to 12 years and were recruited through an autism clinic. Intervention was provided for two 50-min individual sessions per week for a total of 21-33 sessions (depending on the student). Children's spontaneous stories, collected weekly, were analyzed for overall story complexity, story structure, and the use of mental state and causal language. Following a multiple-baseline across-participants design, data were collected for lagged baseline and intervention phases over a 6-month period. All of the children made gains on all 3 measures of narration after participating in the instruction, with clear changes in level for all 5 children and changes in trend for 4 of the 5 children. The gains were maintained after intervention was discontinued. The results demonstrate the efficacy of the 3-phase narrative instruction program for improving the fictional narration abilities of children with ASD.

Narrative theory: II. Self-generated and experimenter-provided negative income shock narratives increase delay discounting.

Science.gov (United States)

Mellis, Alexandra M; Snider, Sarah E; Bickel, Warren K

2018-04-01

Reading experimenter-provided narratives of negative income shock has been previously demonstrated to increase impulsivity, as measured by discounting of delayed rewards. We hypothesized that writing these narratives would potentiate their effects of negative income shock on decision-making more than simply reading them. In the current study, 193 cigarette-smoking individuals from Amazon Mechanical Turk were assigned to either read an experimenter-provided narrative or self-generate a narrative describing either the negative income shock of job loss or a neutral condition of job transfer. Individuals then completed a task of delay discounting and measures of affective response to narratives, as well as rating various narrative qualities such as personal relevance and vividness. Consistent with past research, narratives of negative income shock increased delay discounting compared to control narratives. No significant differences existed in delay discounting after self-generating compared to reading experimenter-provided narratives. Positive affect was lower and negative affect was higher in response to narratives of job loss, but affect measures did not differ based on whether narratives were experimenter-provided or self-generated. All narratives were rated as equally realistic, but self-generated narratives (whether negative or neutral) were rated as more vivid and relevant than experimenter-provided narratives. These results indicate that the content of negative income shock narratives, regardless of source, consistently drives short-term choices. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Topical or systemic 16,16 dm prostaglandin E2 or WR-2721 (WR-1065) protects mice from alopecia after fractionated irradiation

International Nuclear Information System (INIS)

Geng, L.; Malkinson, F.D.; Hanson, W.R.

1992-01-01

Previous studies in mice demonstrated that systemic or topical 16,16 dm PGE 2 protected against single dose radiation-induced hair loss. The authors have now investigated prostaglandin, or WR-2721, protection against murine alopecia produced by varying doses and schedules of fractionated radiation. In some studies with the radioprotectors given systematically, WR-2721 afforded slightly greater radioprotection than 16,16 dm PGE 2 . The two compounds were essentially equally radioprotective in the topical application studies. Since both systemic and topical applications of the agents tested enhanced hair regrowth following radiation, the authors conclude that clinical use of these compounds may provide some protection of hair follicles, and perhaps other tissues, lying within a radiation therapy field. (author)

Annotating risk factors for heart disease in clinical narratives for diabetic patients.

Science.gov (United States)

Stubbs, Amber; Uzuner, Özlem

2015-12-01

The 2014 i2b2/UTHealth natural language processing shared task featured a track focused on identifying risk factors for heart disease (specifically, Cardiac Artery Disease) in clinical narratives. For this track, we used a "light" annotation paradigm to annotate a set of 1304 longitudinal medical records describing 296 patients for risk factors and the times they were present. We designed the annotation task for this track with the goal of balancing annotation load and time with quality, so as to generate a gold standard corpus that can benefit a clinically-relevant task. We applied light annotation procedures and determined the gold standard using majority voting. On average, the agreement of annotators with the gold standard was above 0.95, indicating high reliability. The resulting document-level annotations generated for each record in each longitudinal EMR in this corpus provide information that can support studies of progression of heart disease risk factors in the included patients over time. These annotations were used in the Risk Factor track of the 2014 i2b2/UTHealth shared task. Participating systems achieved a mean micro-averaged F1 measure of 0.815 and a maximum F1 measure of 0.928 for identifying these risk factors in patient records. Copyright © 2015 Elsevier Inc. All rights reserved.

Acquired generalised neuromyotonia, cutaneous lupus erythematosus and alopecia areata in a patient with myasthenia gravis.

LENUS (Irish Health Repository)

O'Sullivan, S S

2012-02-03

We describe a patient with the diagnoses of acquired neuromyotonia, cutaneous lupus erythematosus and alopecia areata, occurring many years after a thymectomy for myasthenia gravis associated with a thymoma. We review the current literature on autoimmune conditions associated with myasthenia gravis and thymectomy. To our knowledge, this combination of multiple autoimmune conditions has not been reported previously.

Narrative work? What on earth?

NARCIS (Netherlands)

J. Woudenberg; L. Bobbink; E. Geurts; M. Pelzer; H. Degen-Nijeboer

2013-01-01

This book is about narrative methods and narrative research. The word narrativity derives from the Latin word narrare, which means ‘to tell’. Narratives are present everywhere. They come in the form of fairy tales, drama, drawings, art, history, biography, myths and legends. Narratives can be found

Narrative Means to Preventative Ends: A Narrative Engagement Framework for Designing Prevention Interventions

Science.gov (United States)

Miller-Day, Michelle; Hecht, Michael L.

2013-01-01

This paper describes a Narrative Engagement Framework (NEF) for guiding communication-based prevention efforts. This framework suggests that personal narratives have distinctive capabilities in prevention. The paper discusses the concept of narrative, links narrative to prevention, and discusses the central role of youth in developing narrative interventions. As illustration, the authors describe how the NEF is applied in the keepin’ it REAL adolescent drug prevention curriculum, pose theoretical directions, and offer suggestions for future work in prevention communication. PMID:23980613

Narrative analysis: how students learn from stories of practice.

Science.gov (United States)

Edwards, Sharon Lorraine

2016-01-01

To describe and recommend a variety of data analysis methods when engaging in narrative research using story as an aid to nursing students' learning. Narrative research methodology is used in many nursing research studies. However, narrative research reports are generally unspecific regarding the analysis and interpretive process. This article examines the qualitative analytical approaches of Lieblich et al's ( 1998 ) narrative processes of holistic content and analysis of form, incorporated as overarching theories. To support these theories and to provide a more rounded analytical process, other authors' work is included. Approaching narrative analysis from different perspectives is recommended. For each cycle of analysis, it is important to conceptualise the analysis using descriptors drawn from the initial literature review and the initial text. Rigour and transparency are foremost, and tables are generated that reflect each stage of the analysis. The final stage of analysis is to clearly report, organise and present findings to reflect the richly varied and diverse potential of stories. Engaging in narrative research and then dealing with the large quantities of data to analyse can be daunting, difficult to manage and appear complex. It is also challenging and rewarding. With clear descriptors, examining the data using multiple lenses can serve to develop a greater level of insight into understanding nursing students' learning from their clinical experiences, presented as stories, when involved in the care of individuals. There are many approaches to narrative analysis in nursing research and it can be difficult to establish the main research approach best suited to the study. There is no single way to define narrative analysis and a combination of strategies can be applied.

Enhancing Evidence-Based Public Health Policy: Developing and Using Policy Narratives.

Science.gov (United States)

Troy, Lisa M; Kietzman, Kathryn G

2016-06-01

Academic researchers and clinicians have a critical role in shaping public policies to improve the health of an aging America. Policy narratives that pair personal stories with research statistics are a powerful tool to share knowledge generated in academic and clinical settings with policymakers. Effective policy narratives rely on a trustworthy and competent narrator and a compelling story that highlights the personal impact of policies under consideration and academic research that bolsters the story. Awareness of the cultural differences in the motivations, expectations, and institutional constraints of academic researchers and clinicians as information producers and U.S. Congress and federal agencies as information users is critical to the development of policy narratives that impact policy decisions. The current article describes the development and use of policy narratives to bridge cultures and enhance evidence-based public health policies that better meet the needs of older adults. [Journal of Gerontological Nursing, 42(6), 11-17.]. Copyright 2016, SLACK Incorporated.

Does narrative perspective influence readers’ perspective-taking? An empirical study on free indirect discourse, psycho-narration and first-person narration

Directory of Open Access Journals (Sweden)

Susanna Salem

2017-06-01

Full Text Available It is often assumed that narrating a story from the protagonist’s perspective increases the readers’ inclination to take over this perspective. In a questionnaire study, we examined to which degree different textual modes of narration (a increase the degree to which the reader can generally relate to the protagonist (what we will call 'relatedness', (b make the reader prone to imagine the scene from the 'spatial point-of-view 'of the protagonist, and (c enhance the psychological perspective-taking of the reader, measured as 'identification 'with the protagonist. We employed two different types of texts—one literary and one non-literary—and tested them in four different modes of narration: free indirect discourse, psycho-narration, first-person narration and external focalization. In terms of the 'relatedness 'between the reader and protagonist and 'spatial perspective-taking 'the largest differences (descriptively occurred between external focalization and psycho-narration ('p'& .05 for 'relatedness', 'p'& .05 for 'spatial perspective-taking' and between external focalization and first-person narration ('p'& .05 for 'relatedness', for 'spatial perspective-taking p'& .1. 'Identification', measured with items from a questionnaire on reading experience (Appel et al. 2002, was highest for first-person narration. Here, the difference between first-person narration and external focalization turned out significant only after including dispositional empathy, thematic interest for the text and attention during reading as covariates. Results for the other two perspective-taking measures were unaffected by the inclusion of the same covariates. In conclusion, our data show that first-person and psycho-narration increased the tendency to take over the perspective of the protagonist, but FID did not.   This article is part of the special collection: Perspective Taking

Narration and Escalation. An Empirical Study of Conflict Narratives

Directory of Open Access Journals (Sweden)

Evelyn Gius

2016-06-01

Full Text Available This article describes the methodology and the outcomes of an empirical study of conflict narratives. The narratological analysis deployed narratological catego­ries in the structuralist tradition based on Genette and was conducted with the help of the text annotation tool CATMA. The analysis aimed at covering as many narratological phenomena as possible by establishing 14 fields of narrato­logical phenomena that were annotated in a corpus of 39 factual narratives about situations at the workplace with and without conflicts. The evaluation of approximately 28,000 annotations brought to light a series of interrelations be­tween narratological phenomena and the presence or absence of conflicts in the narratives. Additionally, this approach led to the identification of some over­sights of narrative theory by detecting hitherto unnoticed interrelations among narratological concepts.

Quantifying narrative ability in autism spectrum disorder: a computational linguistic analysis of narrative coherence.

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Losh, Molly; Gordon, Peter C

2014-12-01

Autism is a neurodevelopmental disorder characterized by serious difficulties with the social use of language, along with impaired social functioning and ritualistic/repetitive behaviors (American Psychiatric Association in Diagnostic and statistical manual of mental disorders: DSM-5, 5th edn. American Psychiatric Association, Arlington, 2013). While substantial heterogeneity exists in symptom expression, impairments in language discourse skills, including narrative (or storytelling), are universally observed in autism (Tager-Flusberg et al. in Handbook on autism and pervasive developmental disorders, 3rd edn. Wiley, New York, pp 335-364, 2005). This study applied a computational linguistic tool, Latent Semantic Analysis (LSA), to objectively characterize narrative performance in high-functioning individuals with autism and typically-developing controls, across two different narrative contexts that differ in the interpersonal and cognitive demands placed on the narrator. Results indicated that high-functioning individuals with autism produced narratives comparable in semantic content to those produced by controls when narrating from a picture book, but produced narratives diminished in semantic quality in a more demanding narrative recall task. This pattern is similar to that detected from analyses of hand-coded picture book narratives in prior research, and extends findings to an additional narrative context that proves particularly challenging for individuals with autism. Results are discussed in terms of the utility of LSA as a quantitative, objective, and efficient measure of narrative ability.

ACADEMIC GENEALOGIES WITH RESPECT TO NARRATIVE IN HUMAN AND SOCIAL SCIENCES AND THEIR IMPLICATION FOR PUBLIC POLICIES

Science.gov (United States)

Fujii, Satoshi; Hasegawa, Taiki; Nakano, Takeshi; Hatori, Tsuyoshi

In human and society science, narrative is regarded as an important issue to understand dynamic actions of human being and society. Therefore, narrative is also expected to be important for public policies that try to improve dynamic actions of human being and society. In th is study, we review academic genealogies with respect to narratives including western philosophy, hermeneutics, historical science, historical philosophy, literary criticism, clinical psychology and sociology, narrative psychology and folklore. Then we discuss how narrative can be pragmatically applied for public policies.

Are specific emotions narrated differently?

Science.gov (United States)

Habermas, Tilmann; Meier, Michaela; Mukhtar, Barbara

2009-12-01

Two studies test the assertion that anger, sadness, fear, pride, and happiness are typically narrated in different ways. Everyday events eliciting these 5 emotions were narrated by young women (Study 1) and 5- and 8-year-old girls (Study 2). Negative narratives were expected to engender more effort to process the event, be longer, more grammatically complex, more often have a complication section, and use more specific emotion labels than global evaluations. Narratives of Hogan's (2003) juncture emotions anger and fear were expected to focus more on action and to contain more core narrative sections of orientation, complication, and resolution than narratives of the outcome emotions sadness and happiness. Hypotheses were confirmed for adults except for syntactic complexity, whereas children showed only some of these differences. Hogan's theory that juncture emotions are restricted to the complication section was not confirmed. Finally, in adults, indirect speech was more frequent in anger narratives and internal monologue in fear narratives. It is concluded that different emotions should be studied in how they are narrated, and that narratives should be analyzed according to qualitatively different emotions.

Systemic therapy and attachment narratives: Attachment Narrative Therapy.

Science.gov (United States)

Dallos, Rudi; Vetere, Arlene

2014-10-01

This article outlines an integration of attachment theory with narrative theory and systemic theory and practice: Attachment Narrative Therapy (ANT). This integration offers a more powerful explanatory formulation of the development and maintenance of human distress in relationships, families and communities, and gives direction to psychotherapeutic intervention. © The Author(s) 2014.

Enhanced biological processes associated with alopecia in polar bears (Ursus maritimus)

Science.gov (United States)

Bowen, Lizabeth; Miles, A. Keith; Stott, Jeffrey L.; Waters, Shannon C.; Atwood, Todd C.

2015-01-01

Populations of wildlife species worldwide experience incidents of mass morbidity and mortality. Primary or secondary drivers of these events may escape classical detection methods for identifying microbial insults, toxin exposure, or additional stressors. In 2012, 28% of polar bears sampled in a study in the southern Beaufort Sea region of Alaska had varying degrees of alopecia that was concomitant with reduced body condition. Concurrently, elevated numbers of sick or dead ringed seals were detected in the southern Beaufort, Chukchi, and Bering seas in 2012, resulting in the declaration of an unusual mortality event (UME) by the National Oceanic and Atmospheric Administration (NOAA). The primary and possible ancillary causative stressors of these events are unknown, and related physiological changes within individual animals have been undetectable using classical diagnostic methods. Here we present an emerging technology as a potentially guiding investigative approach aimed at elucidating the circumstances responsible for the susceptibility of certain polar bears to observed conditions. Using transcriptomic analysis we identified enhanced biological processes including immune response, viral defense, and response to stress in polar bears with alopecia. Our results support an alternative mechanism of investigation into the causative agents that, when used proactively, could serve as an early indicator for populations and species at risk. We suggest that current or classical methods for investigation into events of unusual morbidity and mortality can be costly, sometimes unfocused, and often inconclusive. Advances in technology allow for implementation of a holistic system of surveillance and investigation that could provide early warning of health concerns in wildlife species important to humans.

Enhanced biological processes associated with alopecia in polar bears (Ursus maritimus).

Science.gov (United States)

Bowen, Lizabeth; Miles, A Keith; Stott, Jeffrey; Waters, Shannon; Atwood, Todd

2015-10-01

Populations of wildlife species worldwide experience incidents of mass morbidity and mortality. Primary or secondary drivers of these events may escape classical detection methods for identifying microbial insults, toxin exposure, or additional stressors. In 2012, 28% of polar bears sampled in a study in the southern Beaufort Sea region of Alaska had varying degrees of alopecia that was concomitant with reduced body condition. Concurrently, elevated numbers of sick or dead ringed seals were detected in the southern Beaufort, Chukchi, and Bering seas in 2012, resulting in the declaration of an unusual mortality event (UME) by the National Oceanic and Atmospheric Administration (NOAA). The primary and possible ancillary causative stressors of these events are unknown, and related physiological changes within individual animals have been undetectable using classical diagnostic methods. Here we present an emerging technology as a potentially guiding investigative approach aimed at elucidating the circumstances responsible for the susceptibility of certain polar bears to observed conditions. Using transcriptomic analysis we identified enhanced biological processes including immune response, viral defense, and response to stress in polar bears with alopecia. Our results support an alternative mechanism of investigation into the causative agents that, when used proactively, could serve as an early indicator for populations and species at risk. We suggest that current or classical methods for investigation into events of unusual morbidity and mortality can be costly, sometimes unfocused, and often inconclusive. Advances in technology allow for implementation of a holistic system of surveillance and investigation that could provide early warning of health concerns in wildlife species important to humans. Published by Elsevier B.V.

Narrative descriptions should replace grades and numerical ratings for clinical performance in medical education in the United States

Directory of Open Access Journals (Sweden)

Janice Lynn Hanson

2013-11-01

Full Text Available Background: In medical education, evaluation of clinical performance is based almost universally on rating scales for defined aspects of performance and scores on examinations and checklists. Unfortunately, scores and grades do not capture progress and competence among learners in the complex tasks and roles required to practice medicine. While the literature suggests serious problems with the validity and reliability of ratings of clinical performance based on numerical scores, the critical issue is not that judgments about what is observed vary from rater to rater but that these judgments are lost when translated into numbers on a scale. As the Next Accreditation System of the Accreditation Council on Graduate Medical Education (ACGME takes effect, medical educators have an opportunity to create new processes of evaluation to document and facilitate progress of medical learners in the required areas of competence.Proposal and initial experience: Narrative descriptions of learner performance in the clinical environment, gathered using a framework for observation that builds a shared understanding of competence among the faculty, promise to provide meaningful qualitative data closely linked to the work of physicians. With descriptions grouped in categories and matched to milestones, core faculty can place each learner along the milestones’ continua of progress. This provides the foundation for meaningful feedback to facilitate the progress of each learner as well as documentation of progress toward competence.Implications: This narrative evaluation system addresses educational needs as well as the goals of the Next Accreditation System for explicitly documented progress. Educators at other levels of education and in other professions experience similar needs for authentic assessment and, with meaningful frameworks that describe roles and tasks, may also find useful a system built on descriptions of learner performance in actual work settings

Тіе Modern treatment of androgenetic alopecia

Directory of Open Access Journals (Sweden)

V. K. Karnaukhov

2017-01-01

Full Text Available Androgenetic alopecia (AGA is the most common reason for hair loss. Its frequency in Caucasian population is up to 80% in men and 42% in women. Current gold standard for AGA treatment includes minoxidil and/or finasteride. Both drugs have moderate treatment efficacy and can cause significant side effects. Minoxidil is the only option for treatment of AGA in women since finasteride has no efficacy. This review considers actual concepts of molecular mechanisms of pathogenesis and current treatment options of AGA with their limitations and shortcomings. Current state and perspectives of novel approaches to AGA treatment, potentially more effective and safe than minoxidil and finasteride, are described. The review discusses growth factors and cytokines, topical 5-alpha-reductase inhibitors, androgen receptor antagonists, prostaglandin analogs and antagonists, Wnt signaling activators and platelet-rich plasma injections.

Narrator-in-Chief

DEFF Research Database (Denmark)

Herron, Mark A.

. The use of narratives of and by presidents in the White House can be seen as an essential part of the ceremonial role of the presidency. This use of narratives in epideictic speech has increased with modern day interests in the domestic life of the president, and the use of visual mass media......The dissertation Narrator-in-Chief: The Narrative Rhetoric of Barack Obama seeks to show how the concept of “narrative” can be used in rhetorical criticism of presidential speeches, particularly when considering the speeches and the biographical text, Dreams from My Father (1995), of Barack Obama...... as a communication platform for the president. While this has been described as a negative development (Stuckey, 1991; Salmon, 2010) this dissertation argues that narrative rhetoric should not be seen only as a negative part of political rhetoric, but also as a possibly vital way to educate the audience on issues...

What are narratives good for?

Science.gov (United States)

Beatty, John

2016-08-01

Narratives may be easy to come by, but not everything is worth narrating. What merits a narrative? Here, I follow the lead of narratologists and literary theorists, and focus on one particular proposal concerning the elements of a story that make it narrative-worthy. These elements correspond to features of the natural world addressed by the historical sciences, where narratives figure so prominently. What matters is contingency. Narratives are especially good for representing contingency and accounting for contingent outcomes. This will be squared with a common view that narratives leave no room for chance. On the contrary, I will argue, tracing one path through a maze of alternative possibilities, and alluding to those possibilities along the way, is what a narrative does particularly well. Copyright © 2016 Elsevier Ltd. All rights reserved.

Hair regrowth in alopecia areata patients following Stem Cell Educator therapy.

Science.gov (United States)

Li, Yanjia; Yan, Baoyong; Wang, Hepeng; Li, Heng; Li, Quanhai; Zhao, Dong; Chen, Yana; Zhang, Ye; Li, Wenxia; Zhang, Jun; Wang, Shanfeng; Shen, Jie; Li, Yunxiang; Guindi, Edward; Zhao, Yong

2015-04-20

Alopecia areata (AA) is one of the most common autoimmune diseases and targets the hair follicles, with high impact on the quality of life and self-esteem of patients due to hair loss. Clinical management and outcomes are challenged by current limited immunosuppressive and immunomodulating regimens. We have developed a Stem Cell Educator therapy in which a patient's blood is circulated through a closed-loop system that separates mononuclear cells from the whole blood, allows the cells to briefly interact with adherent human cord blood-derived multipotent stem cells (CB-SC), and returns the "educated" autologous cells to the patient's circulation. In an open-label, phase 1/phase 2 study, patients (N = 9) with severe AA received one treatment with the Stem Cell Educator therapy. The median age was 20 years (median alopecic duration, 5 years). Clinical data demonstrated that patients with severe AA achieved improved hair regrowth and quality of life after receiving Stem Cell Educator therapy. Flow cytometry revealed the up-regulation of Th2 cytokines and restoration of balancing Th1/Th2/Th3 cytokine production in the peripheral blood of AA subjects. Immunohistochemistry indicated the formation of a "ring of transforming growth factor beta 1 (TGF-β1)" around the hair follicles, leading to the restoration of immune privilege of hair follicles and the protection of newly generated hair follicles against autoimmune destruction. Mechanistic studies revealed that co-culture with CB-SC may up-regulate the expression of coinhibitory molecules B and T lymphocyte attenuator (BTLA) and programmed death-1 receptor (PD-1) on CD8β(+)NKG2D(+) effector T cells and suppress their proliferation via herpesvirus entry mediator (HVEM) ligands and programmed death-1 ligand (PD-L1) on CB-SCs. Current clinical data demonstrated the safety and efficacy of the Stem Cell Educator therapy for the treatment of AA. This innovative approach produced lasting improvement in hair regrowth in

Platelet-rich plasma-an 'Elixir' for treatment of alopecia: personal experience on 117 patients with review of literature.

Science.gov (United States)

Garg, Suruchi; Manchanda, Shweta

2017-01-01

Platelet-rich plasma (PRP) has emerged as a new treatment modality in regenerative plastic surgery and dermatology. PRP is a simple, cost-effective and feasible treatment option with high patient satisfaction for hair loss and can be regarded as a valuable adjuvant treatment modality for androgenic alopecia and other types of non-scarring alopecias. Authors have proposed a hair model termed "Golden anchorage with 'molecular locking' of ectodermal and mesenchymal components for survival and integrity of hair follicle (HF)" in this article. Golden anchorage comprises of bulge stem cells, ectodermal basement membrane and bulge portion of APM. PRP with its autologous supply of millions of growth factors works on 'Golden anchorage' along with keratinocytes (PDGF), dermal papilla (IGF and fibroblast growth factor), vasculature (VEGF and PDGF) and neural cells (Nerve Growth Factor) in a multipronged manner serving as an 'elixir' for hair growth and improving overall environment.

Narrative Abilities of Monolingual and Bilingual Children with and without Language Impairment: Implications for Clinical Practice

Science.gov (United States)

Boerma, Tessel; Leseman, Paul; Timmermeister, Mona; Wijnen, Frank; Blom, Elma

2016-01-01

Background: Understanding and expressing a narrative's macro-structure is relatively independent of experience in a specific language. A narrative task is therefore assumed to be a less biased method of language assessment for bilingual children than many other norm-referenced tests and may thus be particularly valuable to identify language…

Automated systems for the de-identification of longitudinal clinical narratives: Overview of 2014 i2b2/UTHealth shared task Track 1.

Science.gov (United States)

Stubbs, Amber; Kotfila, Christopher; Uzuner, Özlem

2015-12-01

The 2014 i2b2/UTHealth Natural Language Processing (NLP) shared task featured four tracks. The first of these was the de-identification track focused on identifying protected health information (PHI) in longitudinal clinical narratives. The longitudinal nature of clinical narratives calls particular attention to details of information that, while benign on their own in separate records, can lead to identification of patients in combination in longitudinal records. Accordingly, the 2014 de-identification track addressed a broader set of entities and PHI than covered by the Health Insurance Portability and Accountability Act - the focus of the de-identification shared task that was organized in 2006. Ten teams tackled the 2014 de-identification task and submitted 22 system outputs for evaluation. Each team was evaluated on their best performing system output. Three of the 10 systems achieved F1 scores over .90, and seven of the top 10 scored over .75. The most successful systems combined conditional random fields and hand-written rules. Our findings indicate that automated systems can be very effective for this task, but that de-identification is not yet a solved problem. Copyright © 2015 Elsevier Inc. All rights reserved.

GIS-facilitated spatial narratives

DEFF Research Database (Denmark)

Møller-Jensen, Lasse; Jeppesen, Henrik; Kofie, Richard Y.

2008-01-01

on the thematically and narrative linking of a set of locations within an area. A spatial narrative that describes the - largely unsuccessful - history of Danish plantations on the Gold Coast (1788-1850) is implemented through the Google Earth client. This client is seen both as a type of media in itself for ‘home......-based' exploration of sites related to the narrative and as a tool that facilitates the design of spatial narratives before implementation within portable GIS devices. The Google Earth-based visualization of the spatial narrative is created by a Python script that outputs a web-accessible KML format file. The KML...

Randomized trial of electrodynamic microneedle combined with 5% minoxidil topical solution for the treatment of Chinese male Androgenetic alopecia.

Science.gov (United States)

Bao, Linlin; Gong, Lin; Guo, Menger; Liu, Taoming; Shi, Anyu; Zong, Haifeng; Xu, Xuegang; Chen, Hongduo; Gao, Xinghua; Li, Yuanhong

2017-10-13

In treating androgenetic alopecia, 5% minoxidil is a commonly used topical drug. By using electrodynamic microneedle at the same time may increase absorption of minoxidil and further stimulate hair growth. A 24-week, randomized, evaluator blinded, comparative study was performed to evaluate the efficacy of treating Chinese male androgenetic alopecia using microneedle combined with 5% minoxidil topical solution. Randomized subjects received topical 5% minoxidil (group 1, n = 20), local electrodynamic microneedle treatments (group 2, n = 20), or local electrodynamic microneedle treatments plus topical 5% minoxidil (group 3, n = 20). A total of 12 microneedle treatments were performed every 2 weeks with 2ml 5% minoxidil delivery in group 3 during each microneedle treatment. Patient receiving topical 5% minoxidil applied 1 ml of the solution twice daily over the course of the study. A total of 60 Chinese male subjects with Norwood-Hamilton type III-VI androgenetic alopecia were treated. The mean improvement in total hair density from baseline to 24 weeks was 18.8/cm 2 in group 1, 23.4/cm 2 in group 2, and 38.3/cm 2 in group 3. The hair growth in the 3 groups was significantly different (P = 0.002), but there were no significant differences in toxicity found between the 3 groups. Treatment with microneedle plus topical 5% minoxidil was associated with the best hair growth.

Discourse on Narrative Research: The Construction Zone--Literary Elements in Narrative Research

Science.gov (United States)

Coulter, Cathy A.; Smith, Mary Lee

2009-01-01

Narrative research has become part of the landscape of education inquiry, yet its theory and practice are still debated and evolving. This article addresses the construction of narratives using literary elements common to nonfiction and fiction writings. The authors discuss these elements and use four narratives to illustrate them. They address…

Supportive Cryotherapy: A Review from Head to Toe

Science.gov (United States)

Kadakia, Kunal C.; Rozell, Shaina A.; Butala, Anish A.; Loprinzi, Charles L.

2013-01-01

Context Conventional chemotherapy leads to multiple adverse mucocutaneous complications including oral mucositis, alopecia, ocular toxicity, and onycholysis. Limited pharmacologic interventions are available for preventing these clinical problems. Objectives This study aimed to critically review the role of cryotherapy (regional hypothermia) for alleviating these adverse symptoms. Methods A narrative review was performed, with an emphasis on randomized controlled trials. A comprehensive search using PubMed, Ovid, Embase, and MEDLINE® was completed. References of all cited articles also were reviewed. Data from the review were comprised of articles published between 1970 to May 2013. Results Available evidence suggests that regional hypothermia decreases the burden of chemotherapy-related oral mucositis, alopecia, ocular toxicity, and onycholysis. The major limitations of studies include the absence of blinded control groups and variable clinical endpoints. Conclusion Regional hypothermia decreases the burden of these four chemotherapy-induced complications and is well tolerated. More research is needed to determine what subgroups of cancer patients are most likely to respond to different types of regional hypothermia, the ideal duration of cooling needed, and to further improve the ease of use of the cooling devices. PMID:24210702

Topical Minoxidil: Systematic Review and Meta-Analysis of Its Efficacy in Androgenetic Alopecia.

Science.gov (United States)

Gupta, Aditya K; Charrette, Andrew

2015-01-01

Topical minoxidil has become a mainstay in the treatment of androgenetic alopecia (AGA). Despite being a longstanding treatment for AGA, relatively few reviews of its efficacy have been published. The current study sought to synthesize the available efficacy data by performing a systematic review of the literature and conducting random-effects pairwise meta-analyses for the outcomes percent increase in hair count from baseline, investigator assessment, and patient self-assessment. Results showed that minoxidil is more effective than placebo in promoting total and nonvellus hair growth (mean difference [MD], 16.68; 95% confidence interval [CI], 9.34-24.03 and MD, 20.90; 95% CI, 9.07-32.74). A significantly higher proportion of participants in the minoxidil group had greater hair growth than participants in the placebo group as judged by both investigators and self-reports (relative risk [RR], 2.28; 95% CI, 1.58-3.31 and RR, 1.56; 95% CI, 1.34-1.80). Despite significant clinical efficacy, cosmetically acceptable results are present in only a subset of patients. Compliance is thought to be a major limiting factor and is being addressed by novel formulations and combinations.

Mechanism of action of minoxidil in the treatment of androgenetic alopecia is likely mediated by mitochondrial adenosine triphosphate synthase-induced stem cell differentiation.

Science.gov (United States)

Goren, A; Naccarato, T; Situm, M; Kovacevic, M; Lotti, T; McCoy, J

2017-01-01

Topical minoxidil is the only topical drug approved by the US Food and Drug Administration (FDA) for the treatment of androgenetic alopecia. However, the exact mechanism by which minoxidil stimulates anagen phase and promotes hair growth is not fully understood. In the late telegen phase of the hair follicle growth cycle, stem cells located in the bulge region differentiate and re-enter anagen phase, a period of growth lasting 2-6 years. In androgenetic alopecia, the anagen phase is shortened and a progressive miniaturization of hair follicles occurs, eventually leading to hair loss. Several studies have demonstrated that minoxidil increases the amount of intracellular Ca2+, which has been shown to up-regulate the enzyme adenosine triphosphate (ATP) synthase. A recent study demonstrated that ATP synthase, independent of its role in ATP synthesis, promotes stem cell differentiation. As such, we propose that minoxidil induced Ca2+ influx can increase stem cell differentiation and may be a key factor in the mechanism by which minoxidil facilitates hair growth. Based on our theory, we provide a roadmap for the development of a new class of drugs for the treatment of androgenetic alopecia.

Evaluation on the use of animated narrative video in teaching narrative text

Directory of Open Access Journals (Sweden)

Soe’oed Rahmat

2018-01-01

Full Text Available In the 21st century, our life is strongly affected by the information technology. Educational technology has been rapidly improved by the development of audiovisual tools. Teachers may choose a number of different types of resources for teaching purposes, including videos and movies. Therefore, this study is aimed at evaluating animated narrative videos from YouTube for the teaching narrative text and identifying potential factors which influence the quality of educational videos. The videos were examined by using assessment rubric to see the quality and suitability of animated narrative videos which might be used in the teaching narrative text. The rubric was adapted from Prince Edward Island (PEI Department of Education: Evaluation and Selection of Learning Resources. It consists of four criteria, content, structure, instructional design, and technical design In addition, the study presents critical awareness of how these aspects can be interpreted to measure animated narrative videos and at the same time the engagement of the teachers in exploring animated narrative videos used in classroom.

Androgenetic Alopecia: Identification of Four Genetic Risk Loci and Evidence for the Contribution of WNT Signaling to Its Etiology

NARCIS (Netherlands)

Heilmann, S.; Kiefer, A.K.; Fricker, N.; Drichel, D.; Hillmer, A.M.; Herold, C.; Tung, J.Y.; Eriksson, N.; Redler, S.; Betz, R.C.; Li, R.; Karason, A.; Nyholt, D.R.; Song, K.; Vermeulen, S.; Kanoni, S.; Dedoussis, G.; Martin, N.G.; Kiemeney, L.A.L.M.; Mooser, V.; Stefansson, K.; Richards, J.B.; Becker, T.; Brockschmidt, F.F.; Hinds, D.A.; Nothen, M.M.

2013-01-01

The pathogenesis of androgenetic alopecia (AGA, male-pattern baldness) is driven by androgens, and genetic predisposition is the major prerequisite. Candidate gene and genome-wide association studies have reported that single-nucleotide polymorphisms (SNPs) at eight different genomic loci are

Narrative House: A Metaphor For Narrative Therapy: Tribute To ...

African Journals Online (AJOL)

This article is a tribute to Michael White, co-founder of narrative therapy, who passed away on 5 April 2008. Michael White and David Epston founded a substantial and ground-breaking psychological movement based on narrative therapy. Michael touched with dignity and changed for the better the lives of thousands.

Alopecia in a viable phospholipase C delta 1 and phospholipase C delta 3 double mutant.

Directory of Open Access Journals (Sweden)

Fabian Runkel

Full Text Available BACKGROUND: Inositol 1,4,5trisphosphate (IP(3 and diacylglycerol (DAG are important intracellular signalling molecules in various tissues. They are generated by the phospholipase C family of enzymes, of which phospholipase C delta (PLCD forms one class. Studies with functional inactivation of Plcd isozyme encoding genes in mice have revealed that loss of both Plcd1 and Plcd3 causes early embryonic death. Inactivation of Plcd1 alone causes loss of hair (alopecia, whereas inactivation of Plcd3 alone has no apparent phenotypic effect. To investigate a possible synergy of Plcd1 and Plcd3 in postnatal mice, novel mutations of these genes compatible with life after birth need to be found. METHODOLOGY/PRINCIPAL FINDINGS: We characterise a novel mouse mutant with a spontaneously arisen mutation in Plcd3 (Plcd3(mNab that resulted from the insertion of an intracisternal A particle (IAP into intron 2 of the Plcd3 gene. This mutation leads to the predominant expression of a truncated PLCD3 protein lacking the N-terminal PH domain. C3H mice that carry one or two mutant Plcd3(mNab alleles are phenotypically normal. However, the presence of one Plcd3(mNab allele exacerbates the alopecia caused by the loss of functional Plcd1 in Del(9olt1Pas mutant mice with respect to the number of hair follicles affected and the body region involved. Mice double homozygous for both the Del(9olt1Pas and the Plcd3(mNab mutations survive for several weeks and exhibit total alopecia associated with fragile hair shafts showing altered expression of some structural genes and shortened phases of proliferation in hair follicle matrix cells. CONCLUSIONS/SIGNIFICANCE: The Plcd3(mNab mutation is a novel hypomorphic mutation of Plcd3. Our investigations suggest that Plcd1 and Plcd3 have synergistic effects on the murine hair follicle in specific regions of the body surface.

Hereditary 1,25-dihydroxyvitamin D-resistant rickets with alopecia resulting from a novel missense mutation in the DNA-binding domain of the vitamin D receptor

Science.gov (United States)

Malloy, Peter J.; Wang, Jining; Srivastava, Tarak; Feldman, David

2009-01-01

The rare genetic recessive disease, hereditary vitamin D resistant rickets (HVDRR), is caused by mutations in the vitamin D receptor (VDR) that result in resistance to the active hormone 1,25-dihydroxyvitamin D3 (1,25-(OH)2D3 or calcitriol). In this study, we examined the VDR from a young boy with clinical features of HVDRR including severe rickets, hypocalcemia, hypophosphatemia and partial alopecia. The pattern of alopecia was very unusual with areas of total baldness, adjacent to normal hair and regions of scant hair. The child failed to improve on oral calcium and vitamin D therapy but his abnormal chemistries and his bone x-rays normalized with intravenous calcium therapy. We found that the child was homozygous for a unique missense mutation in the VDR gene that converted valine to methionine at amino acid 26 (V26M) in the VDR DNA-binding domain (DBD). The mutant VDR was studied in the patient’s cultured skin fibroblasts and found to exhibit normal [3H]1,25-(OH)2D3 binding and protein expression. However, the fibroblasts were unresponsive to treatment with high concentrations of 1,25(OH)2D3 as demonstrated by their failure to induce CYP24A1 gene expression, a marker of 1,25(OH)2D3 responsiveness. We recreated the V26M mutation in the WT VDR and showed that in transfected COS-7 cells the mutation abolished 1,25(OH)2D3-mediated transactivation. The mutant VDR exhibited normal ligand-induced binding to RXRα and to the coactivator DRIP205. However, the V26M mutation inhibited VDR binding to a consensus vitamin D response element (VDRE). In summary, we have identified a novel V26M mutation in the VDR DBD as the molecular defect in a patient with HVDRR and an unusual pattern of alopecia. PMID:19815438

Cinematic narratives of Sonderkommando: Son of saul or narrating the victim, perpetrator, trauma and death

Directory of Open Access Journals (Sweden)

Daković Nevena

2016-01-01

Full Text Available The aim of this paper is to map out - by analysing the film Son of Saul, but also by its comparison with two other films dealing with the topic, Himmelkommando and The Grey Zone, the narrative mechanism that satisfies the complex ethical and aesthetical demands imposed by the theme of Sonderkommando as the particular episode of the Holocaust. The key element of the narrative structure is the construction of the Levi’s “dead and drowned” witness who “resurrected” through the narrative intervention becomes the only reliable and credible narrator of the historical trauma. The prerequisite for his emergence is the narration and representation of the death which makes but also solves the traumatised - understood as multiple, fragmented, opposed - identities of the members of the special squad. Their entangled identity involves the simultaneous presence of a victim, perpetrator, witness and the authentic narrator of the trauma of the death camp. The death of the perpetrator is the condition sina qua non for the emergence of the figure of the victim-witness narrator but also for making of narrative which overcomes the initial trauma of the Holocaust. The detailed analysis of the film Son of Saul confirms and identifies these narratives as the modernist narration of the post-traumatic film.

Clinical Features and Management of Cartilage-Hair Hypoplasia: A Narrative Review

Directory of Open Access Journals (Sweden)

Kobra Shiasi Arani

2015-01-01

Full Text Available Context: Cartilage-hair hypoplasia is a rare hereditary cause of short stature. The aim of this study was to familiarize physicians with this rare but important disease. Evidence Acquisition: This article is a narrative review of the scientific literature to inform about clinical features and management of Cartilage-hair hypoplasia. A systematic search identified 127 papers include original and review articles and case reports. Results: Cartilage-Hair Hypoplasia characterized by short-limb dwarfism associated with metaphyseal chondrodysplasia. The inheritance is autosomal recessive. Other findings include hair hypoplasia, anemia, immunodeficiency, propensity to infections, gastrointestinal disorders (Hirschsprung disease, anal stenosis, esophageal atresia and malabsorption, defective spermatogenesis, increased risk of malignancies and higher rate of mortality. Immunodeficiency in cartilage-hair hypoplasia may be an isolated B-cell or isolated T-cell immunodeficiency or combined B and T-cell immunodeficiency; however, severe combined immunodeficiency is rare. There is no known treatment for hair hypoplasia. Growth hormone was used with conflicting results for short stature in children with Cartilage-hair hypoplasia. Skeletal problems must be managed with physiotherapy and appropriate orthopedic interventions. Hirschsprung disease, anal stenosis and esophageal atresia should be surgically corrected. Patients with severe hypoplastic anemia require repeated transfusions. Bone marrow transplantation may be required for patients with severe combined immunodeficiency or severe persistent hypoplastic anemia. Treatment with G-CSF is useful for neutropenia. Patients should be monitored closely for developing malignancy such as skin neoplasms, lymphomas and leukemias. Conclusions: Cartilage-hair hypoplasia is an important hereditary disease with different medical aspects. The high rate of consanguineous marriages in Iran necessitates considering CHH in any

Circumscribed cicatricial alopecia due to localized sarcoidal granulomas and single-organ granulomatous arteritis: a case report and systematic review of sarcoidal vasculitis.

Science.gov (United States)

Yazdani Abyaneh, Mohammad-Ali; Raghu, Preethi; Kircher, Kenneth; Kutzner, Heinz; Kortz, Alison; Carlson, John Andrew

2015-10-01

Vasculitis associated with sarcoid granulomas is an uncommon phenomenon. A 72-year-old female presented with an expanding region of circumscribed alopecia and scalp atrophy of 2 months duration. Biopsy showed non-caseating granulomas, dermal thinning, loss of follicles, fibrosis and muscular vessels disrupted by mixed lymphocyte, macrophage and giant-cell infiltrates. Affected vessels had loss and fragmentation of the elastic lamina, fibrous replacement of their walls and luminal stenosis (endarteritis obliterans). Dermal and vascular advential intralymphatic granulomas and lymphangiectases were found by D2-40 expression, suggesting lymphatic obstruction and poor antigen clearance. No evidence of a post-zoster eruption, systemic sarcoidosis or systemic giant-cell arteritis was found. Two years later, prednisone had halted - but not reversed - progression of her alopecia. Review of the literature showed two types of vasculitis associated with sarcoid granulomas: (i) acute, self-limited leukocytoclastic vasculitis and (ii) chronic granulomatous vasculitis (GV). Persistence of non-degradable material or antigen contributes to the pathogenesis of granulomatous inflammation. In this case, lymphatic obstruction probably impeded clearance of nonimmunologic and/or immunologic stimuli permitting and sustaining the development of sarcoid granulomas and sarcoid GV, ultimately causing scarring alopecia and cutaneous atrophy. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Beyond the Investment Narrative

Science.gov (United States)

Moss, Peter

2013-01-01

The current policy interest in early childhood education and care is driven by an investment narrative, a story of quality and high returns emerging from a dominant neoliberal political economy. This short note expresses deep reservations about this narrative, and hints at another narrative that foregrounds democracy, experimentation and…

Alopecia of IFN-gamma knockout mouse as a model for disturbance of the hair cycle: a unique arrest of the hair cycle at the anagen phase accompanied by mitosis.

Science.gov (United States)

Hirota, Ryuichiro; Tajima, Sadao; Yoneda, Yukio; Tamayama, Takumi; Watanabe, Masahito; Ueda, Kouichi; Kubota, Takahiro; Yoshida, Ryotaro

2002-09-01

Interferon-gamma(-/-) (IFN-gamma(-/-)) and IFN-gamma(+/+) C57BL/6 mice (3 weeks of age) completed the production of morphogenesis-derived hair. Around 6 weeks of age, however, most of the IFN-gamma(-/-) but none of the IFN-gamma(+/+) mice began to lose hairs in the dorsal and occipital areas in the absence of inflammatory reactions, and the alopecia was sustained for at least several 10-week periods of observation. A single subcutaneous injection of IFN-gamma to IFN-gamma(-/-) mice at 3, but not 4, 5, or 8 weeks of age could protect all the mice from alopecia, revealing that the lack of IFN-gamma around 3 weeks of age is directly responsible for the alopecia. Histologic features showed that the hair follicles of the IFN-gamma(+/+) mice passed through the anagen (4-5 weeks of age) and catagen/telogen ( approximately 6 weeks of age) phases, whereas those of IFN-gamma(-/-) mice (5 weeks of age or older) stayed in the anagen phase. TUNEL and bromodeoxyuridine experiments suggested that an arrest with unlimited DNA synthesis of the hair cycle in the anagen phase by the lack of IFN-gamma-dependent apoptosis in the midfollicle region and diffuse shedding of previously formed hair induced alopecia in IFN-gamma(-/-) mice.

Project Narrative

Energy Technology Data Exchange (ETDEWEB)

Driscoll, Mary C. [St. Bonaventure University, St Bonaventure, NY(United States)

2012-07-12

The Project Narrative describes how the funds from the DOE grant were used to purchase equipment for the biology, chemistry, physics and mathematics departments. The Narrative also describes how the equipment is being used. There is also a list of the positive outcomes as a result of having the equipment that was purchased with the DOE grant.

Do Live versus Audio-Recorded Narrative Stimuli Influence Young Children's Narrative Comprehension and Retell Quality?

Science.gov (United States)

Kim, Young-Suk Grace

2016-01-01

Purpose: The primary aim of the present study was to examine whether different ways of presenting narrative stimuli (i.e., live narrative stimuli versus audio-recorded narrative stimuli) influence children's performances on narrative comprehension and oral-retell quality. Method: Children in kindergarten (n = 54), second grade (n = 74), and fourth…

Drama and Imagination: A Cognitive Theory of Drama's Effect on Narrative Comprehension and Narrative Production

Science.gov (United States)

Mages, Wendy K.

2006-01-01

This article proposes a cognitive theory of how drama affects two aspects of language development: narrative comprehension and narrative production. It is a theoretical model that explicitly posits the role of the imagination in drama's potential to enhance the development of both narrative comprehension and narrative production. (Contains 2…

Politics of love: narrative structures, intertextuality and social agency in the narratives of parents with disabled children.

Science.gov (United States)

Hanisch, Halvor

2013-11-01

Recent research has highlighted how parental narratives can be important in the resistance against disabling processes. This article contains analyses of enabling language in narratives published by Scandinavian disability rights organizations. First, drawing on the work of Fisher and Goodley, I point out that the material constitute a threefold: normality narratives, resistance narratives, and narratives that demonstrate an appreciation of the present and the child's individual alterity. Second, I demonstrate that the last narrative draws on Romanticism rather than linguistic resources from disability culture. Third, I show that these narratives are hyperboles - texts that strengthen and emphasise the valuation to the point where the narrative structure transcends narrative consistency. Fourth, drawing on the work of Kristeva, I argue that this form of narration constitutes an intimate politics of love. © 2013 The Author. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Narrative, Preaching, and Formation

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Finney, Mark David

2017-01-01

This dissertation focuses on the place of narrative in the transformational encounter that can take place between hearers of sermons and God. Chapter 1 surveys the history and development of contemporary scholarship related to narrative preaching. It argues that most homileticians consider narrative either as a way of structuring sermons, or as a…

Sammelrezension: Unreliable Narration

OpenAIRE

Orth, Dominik

2009-01-01

Eva Laass: Broken Taboos, Subjective Truths. Forms and Functions of Unreliable Narration in Contemporary American Cinema. A Contribution to Film NarratologyVolker Ferenz: Don’t believe his lies. The unreliable narrator in contemporary American cinema

Why Narrating Changes Memory: A Contribution to an Integrative Model of Memory and Narrative Processes.

Science.gov (United States)

Smorti, Andrea; Fioretti, Chiara

2016-06-01

This paper aims to reflect on the relation between autobiographical memory (ME) and autobiographical narrative (NA), examining studies on the effects of narrating on the narrator and showing how studying these relations can make more comprehensible both memory's and narrating's way of working. Studies that address explicitly on ME and NA are scarce and touch this issue indirectly. Authors consider different trends of studies of ME and NA: congruency vs incongruency hypotheses on retrieving, the way of organizing memories according to gist or verbatim format and their role in organizing positive and negative emotional experiences, the social roots of ME and NA, the rules of conversation based on narrating. Analysis of investigations leads the Authors to point out three basic results of their research. Firstly, NA transforms ME because it narrativizes memories according to a narrative format. This means that memories, when are narrated, are transformed in stories (verbal language) and socialised. Secondly, the narrativization process is determined by the act of telling something within a communicative situation. Thus, relational situation of narrating act, by modifying the story, modifies also memories. The Authors propose the RE.NA.ME model (RElation, NArration, MEmory) to understand and study ME and NA. Finally, this study claims that ME and NA refer to two different types of processes having a wide area of overlapping. This is due to common social, developmental and cultural roots that make NA to include part of ME (narrative of memory) and ME to include part of NA (memory of personal events that have been narrated).

Forensic historiography: narratives and science.

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Drukteinis, Albert M

2014-01-01

Psychiatrists function, in part, as historians who rely on patient narratives to help them understand presenting mental disorders and explain their causes. Forensic psychiatrists have been skeptical of using narratives, raising concerns about their lack of objectivity and potential for bias. They also have criticized narratives as being more performative than scientific. Recent authors, however, have pointed out that narratives may be helpful in forming forensic opinions and supporting oral testimony, while stressing that their use must be consistent with the ethics espoused by forensic psychiatry. This article reviews the role of narratives in understanding human events and the ubiquitous presence of narratives in the judicial process. It delves into the inescapability of using explicit or implicit narratives in the course of forensic practice, as well as how they may be meaningfully incorporated into evaluations and find expression alongside scientific principles. © 2014 American Academy of Psychiatry and the Law.

Personal history, beyond narrative

DEFF Research Database (Denmark)

Køster, Allan

2017-01-01

on a distinction between history and narrative, I outline an account of historical becoming through a process of sedimentation and a rich notion of what I call historical selfhood on an embodied level. Five embodied existentials are suggested, sketching a preliminary understanding of how selves are concretely......Narrative theories currently dominate our understanding of how selfhood is constituted and concretely individuated throughout personal history. Despite this success, the narrative perspective has recently been exposed to a range of critiques. Whilst these critiques have been effective in pointing...... out the shortcomings of narrative theories of selfhood, they have been less willing and able to suggest alternative ways of understanding personal history. In this article, I assess the criticisms and argue that an adequate phenomenology of personal history must also go beyond narrative. Drawing...

Histological assessment of follicular delivery of flutamide by solid lipid nanoparticles: potential tool for the treatment of androgenic alopecia.

Science.gov (United States)

Hamishehkar, Hamed; Ghanbarzadeh, Saeed; Sepehran, Sasan; Javadzadeh, Yousef; Adib, Zahra Mardhiah; Kouhsoltani, Maryam

2016-01-01

Flutamide is a potent anti-androgen with the several unwanted side effects in systemic administration, therefore, it has attracted special interest in the development of topically applied formulations for the treatment of androgenic alopecia. The purpose of this study was to prepare and characterize the solid lipid nanoparticles (SLNs) of Flutamide for follicular targeting in the treatment of the androgenic alopecia. Flutamide-loaded SLNs, promising drug carriers for topical application were prepared by hot melt homogenization method. Drug permeation and accumulation in the exercised rat skin and histological study on the male hamsters were performed to assess drug delivery efficiency in vitro and in vivo, respectively. The optimized Flutamide-loaded SLNs (size 198 nm, encapsulation efficiency percentage 65% and loading efficiency percentage 3.27%) exhibited a good stability during the period of at least 2 months. The results of X-ray diffraction showed Flutamide amorphous state confirming uniform drug dispersion in the SLNs structure. Higher skin drug deposition (1.75 times) of SLN formulation compared to Flutamide hydroalcoholic solution represented better localization of the drug in the skin. The in vivo studies showed more new hair follicle growth by utilizing Flutamide-loaded SLNs than Flutamide hydroalcoholic solution which could be due to the higher accumulation of SLNs in the hair follicles as well as slowly and continues release of the Flutamide through the SLNs maximizing hair follicle exposure by antiandrogenic drug. It was concluded Flutamide-loaded SLN formulation can be used as a promising colloidal drug carriers for topical administration of Flutamide in the treatment of androgenic alopecia.

Health seeking narratives of unwell Sri Lankan Tamil refugees in Melbourne Australia.

Science.gov (United States)

Samuel, Sophia; Advocat, Jenny; Russell, Grant

2018-03-01

Sri Lankan Tamil refugees are among the largest group of refugees to resettle in Australia in the last decade. The aim of this study is to characterise the narratives of health-seeking among unwell Sri Lankan Tamil refugees in Melbourne, Victoria, Australia. Drawing on a qualitative, phenomenological perspective, we conducted in-depth interviews in Tamil and English with 12 participants who identified as being unwell for 6 months or more. Findings revealed three narratives of health-seeking: the search for the 'good life' that was lost or never experienced, seeking help from familiar channels in an unfamiliar context, and the desire for financial and occupational independence. These three narratives are undergirded by the metanarrative of a hope-filled recovery. These narratives of Tamil refugees' lived experience provide new insights into clinical care and health service delivery.

Testimony in Narrative Educational Research: A Qualitative Interview, Narrative Analysis and Epistemological Evaluation

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Christopher, Justin

2017-01-01

The purpose of this study is to assess issues that arise in the context of epistemological claims in narrative educational research by means of narrative analysis and epistemological evaluation. The research questions which guided the study were: 1) To what extent is epistemology considered by narrative educational researchers?; 2) What issues do…

Narrative research in psychotherapy: a critical review.

Science.gov (United States)

Avdi, Evrinomy; Georgaca, Eugenie

2007-09-01

This paper is a review of studies which utilise the notion of narrative to analyse psychotherapy. Its purpose is to systematically present this diverse field of research, to highlight common themes and divergences between different strands and to further the development and integration of narrative research in psychotherapy. The paper reviews studies which employ an applied textual analysis of narratives produced in the context of psychotherapy. Criteria for inclusion of studies are, firstly, the analysis of therapeutic and therapy-related texts and, secondly, the adoption of a narrative psychological perspective. The studies were examined on the basis of the notion of narrative they employ and the aspects of client narratives they focus on, and were grouped accordingly in the review. The majority of the studies reviewed assume a constructivist approach to narrative, adopt a representational view of language, focus primarily on client micro-narratives and relate to cognitive-constructivist and process-experiential psychotherapeutic approaches. A smaller group of studies assume a social constructionist approach to narrative and a functional view of language, focus on micro-narratives, highlight the interactional and wider social aspects of narrative and relate to postmodern trends in psychotherapy. The range of conceptualisations of narrative in the studies reviewed, from a representational psychological view to a constructionist social view, reflects tensions within narrative psychology itself. Moreover, two trends can be discerned in the field reviewed, narrative analysis of therapy, which draws from narrative theory and utilises the analytic approaches of narrative research to study psychotherapy, and analyses of narrative in therapy, which study client narratives using non-narrative qualitative methods. Finally, the paper highlights the need for integration of this diverse field of research and urges for the development of narrative studies of psychotherapy

Narrative Medicine: Community Poetry Heals Young and Old

Science.gov (United States)

Walker, Allison S.

2016-01-01

This is a snapshot of a service learning course founded on narrative medicine, a clinical practice designed to replace impersonal care with empathic listening. By utilizing poetry therapy techniques among nursing home populations, a program called "HPU LifeLines" promotes a community literacy of illness and provides psychological and…

Topical or systemic 16,16 dm prostaglandin E sub 2 or WR-2721 (WR-1065) protects mice from alopecia after fractionated irradiation

Energy Technology Data Exchange (ETDEWEB)

Geng, L.; Malkinson, F.D. (Rush-Presbyterian-St. Luke' s Medical Center, Chicago, IL (United States)); Hanson, W.R. (Hines VA Medical Center, IL (United States))

1992-04-01

Previous studies in mice demonstrated that systemic or topical 16,16 dm PGE{sub 2} protected against single dose radiation-induced hair loss. The authors have now investigated prostaglandin, or WR-2721, protection against murine alopecia produced by varying doses and schedules of fractionated radiation. In some studies with the radioprotectors given systematically, WR-2721 afforded slightly greater radioprotection than 16,16 dm PGE{sub 2}. The two compounds were essentially equally radioprotective in the topical application studies. Since both systemic and topical applications of the agents tested enhanced hair regrowth following radiation, the authors conclude that clinical use of these compounds may provide some protection of hair follicles, and perhaps other tissues, lying within a radiation therapy field. (author).

Narrating Global Order and Disorder

Directory of Open Access Journals (Sweden)

Matthew Levinger

2017-09-01

Full Text Available This thematic issue addresses how strategic narratives affect international order. Strategic narratives are conceived of as stories with a political purpose or narratives used by political actors to affect the behavior of others. The articles in this issue address two significant areas important to the study of international relations: how strategic narratives support or undermine alliances, and how they affect norm formation and contestation. Within a post-Cold War world and in the midst of a changing media environment, strategic narratives affect how the world and its complex issues are understood. This special issue speaks to the difficulties associated with creating creative and committed international cooperation by noting how strategic narratives are working to shape the Post-Cold War international context.

Organizational Remembering as Narrative

DEFF Research Database (Denmark)

Musacchio Adorisio, Anna Linda

2014-01-01

This article focuses on organizational remembering in banking. To provide an alternative to the repository image of memory in organization, organizational remembering is conceptualized as narrative, where narrative represents a way to organize the selection and interpretation of the past....... The narrative perspective deals with both the experiential and contextual nature of remembering by addressing concerns raised by critiques of organizational memory studies, namely, the subjective experience of remembering and the social and historical context in which remembering takes place. Antenarrative...... the narrative perspective reveals ruptures and ambiguities that characterize organizational remembering that would remain hidden in the organizational memory studies approach....

Narrative Making and Remaking in the Early Years: Prelude to the Personal Narrative

Science.gov (United States)

Miller, Peggy J.; Chen, Eva Chian-Hui; Olivarez, Megan

2014-01-01

Although very young children are unable to formulate a personal narrative of the life course, their everyday lives are steeped in narratives. Drawing on ethnographic studies in diverse sociocultural worlds, we argue that the early years of life form a vital preamble to the personal narrative. In this phase of life, the universal predisposition to…

Narrative self-appropriation

DEFF Research Database (Denmark)

Køster, Allan

2017-01-01

is profoundly saturated by an alienness regarding the person’s own affects and responses. However, the balance of familiarity and alienness is not static, but can be cultivated through e.g. psychotherapy. Following this line of thought, I present the idea that narrativising experiences can play an important...... role in processes of appropriating such embodied self-alienness. Importantly, the notion of narrative used is that of a scalar conception of narrativity as a variable quality of experience that comes in degrees. From this perspective, narrative appropriation is a process of gradually attributing...

Comparing deep learning and concept extraction based methods for patient phenotyping from clinical narratives.

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Gehrmann, Sebastian; Dernoncourt, Franck; Li, Yeran; Carlson, Eric T; Wu, Joy T; Welt, Jonathan; Foote, John; Moseley, Edward T; Grant, David W; Tyler, Patrick D; Celi, Leo A

2018-01-01

In secondary analysis of electronic health records, a crucial task consists in correctly identifying the patient cohort under investigation. In many cases, the most valuable and relevant information for an accurate classification of medical conditions exist only in clinical narratives. Therefore, it is necessary to use natural language processing (NLP) techniques to extract and evaluate these narratives. The most commonly used approach to this problem relies on extracting a number of clinician-defined medical concepts from text and using machine learning techniques to identify whether a particular patient has a certain condition. However, recent advances in deep learning and NLP enable models to learn a rich representation of (medical) language. Convolutional neural networks (CNN) for text classification can augment the existing techniques by leveraging the representation of language to learn which phrases in a text are relevant for a given medical condition. In this work, we compare concept extraction based methods with CNNs and other commonly used models in NLP in ten phenotyping tasks using 1,610 discharge summaries from the MIMIC-III database. We show that CNNs outperform concept extraction based methods in almost all of the tasks, with an improvement in F1-score of up to 26 and up to 7 percentage points in area under the ROC curve (AUC). We additionally assess the interpretability of both approaches by presenting and evaluating methods that calculate and extract the most salient phrases for a prediction. The results indicate that CNNs are a valid alternative to existing approaches in patient phenotyping and cohort identification, and should be further investigated. Moreover, the deep learning approach presented in this paper can be used to assist clinicians during chart review or support the extraction of billing codes from text by identifying and highlighting relevant phrases for various medical conditions.

Treating Alopecia Areata: Current Practices Versus New Directions.

Science.gov (United States)

Gupta, Aditya K; Carviel, Jessie; Abramovits, William

2017-02-01

Alopecia areata (AA) is non-scarring hair loss resulting from an autoimmune disorder. Severity varies from patchy hair loss that often spontaneously resolves to severe and chronic cases that can progress to total loss of scalp and body hair. Many treatments are available; however, the efficacy of these treatments has not been confirmed, especially in severe cases, and relapse rates are high. First-line treatment often includes corticosteroids such as intralesional or topical steroids for mild cases and systemic steroids or topical immunotherapy with diphenylcyclopropenone or squaric acid dibutylester in severe cases. Minoxidil and bimatoprost may also be recommended, usually in combination with another treatment. Ongoing research and new insights into mechanisms have led to proposals of innovative therapies. New directions include biologics targeting immune response as well as lasers and autologous platelet-rich plasma therapy. Preliminary data are encouraging, and it is hoped this research will translate into new options for the treatment of AA in the near future.

An analysis of gene expression data involving examination of signaling pathways activation reveals new insights into the mechanism of action of minoxidil topical foam in men with androgenetic alopecia.

Science.gov (United States)

Stamatas, Georgios N; Wu, Jeff; Pappas, Apostolos; Mirmirani, Paradi; McCormick, Thomas S; Cooper, Kevin D; Consolo, Mary; Schastnaya, Jane; Ozerov, Ivan V; Aliper, Alexander; Zhavoronkov, Alex

2017-01-01

Androgenetic alopecia is the most common form of hair loss. Minoxidil has been approved for the treatment of hair loss, however its mechanism of action is still not fully clarified. In this study, we aimed to elucidate the effects of 5% minoxidil topical foam on gene expression and activation of signaling pathways in vertex and frontal scalp of men with androgenetic alopecia. We identified regional variations in gene expression and perturbed signaling pathways using in silico Pathway Activation Network Decomposition Analysis (iPANDA) before and after treatment with minoxidil. Vertex and frontal scalp of patients showed a generally similar response to minoxidil. Both scalp regions showed upregulation of genes that encode keratin associated proteins and downregulation of ILK, Akt, and MAPK signaling pathways after minoxidil treatment. Our results provide new insights into the mechanism of action of minoxidil topical foam in men with androgenetic alopecia.

Marie-Laure Ryan. Kenneth Foote, and Maoz Azaryahu. Narrating Space / Spatializing Narrative : Where Narrative Theory and Geography Meet.

OpenAIRE

Harding, Wendy

2017-01-01

In the wake of Gerard Genette’s Figures I-III, (1967-70) and Paul Ricoeur’s Temps et Récit (1983-85), narratologists have been very much concerned with questions of time. The aim of Narrating Space / Spatializing Narrative : Where Narrative Theory and Geography Meet is to reorient the discipline by studying the ways in which “space can intersect with narrative” (1). To pursue this project, Marie-Laure Ryan, a literary specialist, has joined forces with two geographers, Kenneth Foote and Maoz ...

The efficacy and safety of diphenylcyclopropenone solutions in propylene glycol and isopropanol. A comparative study of two formulas used for the treatment of 100 patients with alopecia areata

Directory of Open Access Journals (Sweden)

Katarzyna Borowska

2017-10-01

Full Text Available Alopecia areata (AA is a T cell-mediated autoimmune disease involving hair follicles characterized by hair loss. 2,3-diphenylcyclopropenone (DCP is a topically administered drug intended for treating AA. The study investigates an efficacy and safety of DCP for the purpose of the treatment of AA. It presents a comparative study of two formulas: DCP in propylene glycol and DCP in isopropanol. While the treatment efficacy in both groups was very simmilar, the tolerance of the DCP in isopropanol was better than DCP in propylene glycol. Authors indicate the potential clinical applications of latter formula.

Narrative accounting disclosures

NARCIS (Netherlands)

Aerts, Walter; Clubb, C.; Imam, S.

2015-01-01

Narrative accounting disclosures are an integral part of the corporate financial reporting package. They are deemed to provide a view of the company “through the eyes of management”. The narratives represent management's construal of corporate events and are largely discretionary. Research in

Narrative Fortresses: Crisis Narratives and Conflict in the Conservation of Mount Gorongosa, Mozambique

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Christy Schuetze

2015-01-01

Full Text Available A single narrative about the Gorongosa Restoration Project (GRP in Mozambique circulates widely in the popular media. This story characterises the project as an innovative intervention into an ecological crisis situation. The narrative hails the project′s aim to use profits from tourism to address the goals of both human development and conservation of biodiversity, and portrays the park project as widely embraced by long-term residents. This representation helps the project attract broad acclaim, donor funding, and socially conscious visitors, yet it obscures the early emergence of unified opposition to the project′s interventions among long-term residents of Gorongosa Mountain. This article draws on ethnographic research conducted on Gorongosa Mountain between 2006 and 2008 to examine the project′s early activities there. I examine two crisis narratives that led to entrenched conflict between park-based actors and mountain residents. Focusing on the emergence and solidification of divergent narratives-narrative fortresses-about the extension of the park′s activities to Gorongosa Mountain offers insight into the powerful role of crisis narratives in producing and maintaining conflict, leading to outcomes counter to the desires of conservationists. Ultimately, the article points to ways in which narratives of environmental crisis work against aspirations of partnership and collaboration with resident populations in conservation and development schemes.

The End of a Noble Narrative?

DEFF Research Database (Denmark)

Manners, Ian James; Murray, Philomena

2016-01-01

the construction and application of an analytical framework drawing on different theoretical perspectives. This framework is then applied to six European integration narratives to demonstrate the value of a narrative approach. The article concludes that narrative analysis provides a means of understanding both EU......, the Nobel Prize and the search for a ‘new narrative for Europe’ demonstrate that the processes of European integration are always narrated as sense-making activities – stories people tell to make sense of their reality. This article argues in favour of a narrative approach to European integration through...

Platelet-rich plasma—an ‘Elixir’ for treatment of alopecia: personal experience on 117 patients with review of literature

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Manchanda, Shweta

2017-01-01

Platelet-rich plasma (PRP) has emerged as a new treatment modality in regenerative plastic surgery and dermatology. PRP is a simple, cost-effective and feasible treatment option with high patient satisfaction for hair loss and can be regarded as a valuable adjuvant treatment modality for androgenic alopecia and other types of non-scarring alopecias. Authors have proposed a hair model termed “Golden anchorage with ‘molecular locking’ of ectodermal and mesenchymal components for survival and integrity of hair follicle (HF)” in this article. Golden anchorage comprises of bulge stem cells, ectodermal basement membrane and bulge portion of APM. PRP with its autologous supply of millions of growth factors works on ‘Golden anchorage’ along with keratinocytes (PDGF), dermal papilla (IGF and fibroblast growth factor), vasculature (VEGF and PDGF) and neural cells (Nerve Growth Factor) in a multipronged manner serving as an ‘elixir’ for hair growth and improving overall environment. PMID:28815175

[Testing the significance of psychic factors in the etiology of alopecia areata. II. Examination of personality by means of Eysenck's Personality Inventory (MPI) adapted by Choynowski].

Science.gov (United States)

Wygledowska-Kania, M; Bogdanowski, T

1995-01-01

We evaluated the role of psychic factors in the etiopathogenesis of alopecia areata on the basis of Eysenck's Personality Inventory adapted by Choynowski. 55 patients were tested (28 women and 27 men). The control group consisted of 50 volunteers. The analysis of the results showed that the neurotic type of personality was predominant in the group of patients (43.64%). Neurotic personality found in such a high percentage of the patients with alopecia areata may be an additional element in the group of psychic factors that possibly have some influence on the development of the disease.

Theoretical perspectives on narrative inquiry.

Science.gov (United States)

Emden, C

1998-04-01

Narrative inquiry is gaining momentum in the field of nursing. As a research approach it does not have any single heritage of methodology and its practitioners draw upon diverse sources of influence. Central to all narrative inquiry however, is attention to the potential of stories to give meaning to people's lives, and the treatment of data as stories. This is the first of two papers on the topic and addresses the theoretical influences upon a particular narrative inquiry into nursing scholars and scholarship. The second paper, Conducting a narrative analysis, describes the actual narrative analysis as it was conducted in this same study. Together, the papers provide sufficient detail for others wishing to pursue a similar approach to do so, or to develop the ideas and procedures according to their own way of thinking. Within this first theoretical paper, perspectives from Jerome Bruner (1987) and Wade Roof (1993) are outlined. These relate especially to the notion of stories as 'imaginative constructions' and as 'cultural narratives' and as such, highlight the profound importance of stories as being individually and culturally meaningful. As well, perspectives on narrative inquiry from nursing literature are highlighted. Narrative inquiry in this instance lies within the broader context of phenomenology.

Classroom-based narrative and vocabulary instruction: results of an early-stage, nonrandomized comparison study.

Science.gov (United States)

Gillam, Sandra Laing; Olszewski, Abbie; Fargo, Jamison; Gillam, Ronald B

2014-07-01

This nonrandomized feasibility study was designed to provide a preliminary assessment of the impact of a narrative and vocabulary instruction program provided by a speech-language pathologist (SLP) in a regular classroom setting. Forty-three children attending 2 first-grade classrooms participated in the study. Children in each classroom were divided into high- and low-risk subgroups on the basis of their performance on a narrative test. Narrative and vocabulary instruction was provided by an SLP in 1 classroom for three 30-min periods per week for 6 weeks. The children in the experimental classroom made clinically significant improvements on narrative and vocabulary measures; children in the comparison classroom did not. Within the experimental classroom, children in the high-risk subgroup demonstrated greater gains in narration and fewer gains in vocabulary than children in the low-risk subgroup. There were no subgroup differences in the comparison classroom. These preliminary results provide early evidence of the feasibility of implementing a narrative instruction program in a classroom setting. Children at a high risk for language difficulties appeared to profit more from the narrative instruction than from the embedded vocabulary instruction. More extensive research on this instructional program is warranted.

Narratives and Accounts: "Post-Crisis" Narration in Annual Company Reports

Science.gov (United States)

Winchester, Jules; Williams, Simon

2014-01-01

This paper aims to provide Business English and EAP practitioners with a rationale for including the analysis of narrative elements in business addresses in their language teaching in order to encourage critical thinking in learners. By studying these elements, and the rhetorical function of the narrative in particular, students can become more…

The dynamics of unreliable narration

DEFF Research Database (Denmark)

Hansen, Per Krogh

2017-01-01

Per Krogh Hansen brings attention to one of the most discussed narratological concepts in recent years, the ‘unreliable narrator’. In the article »The Dynamics of Unreliable Narration«, Hansen is considering to what extent the question of authorial control or intention is relevant when analysing...... and interpreting unreliable narrators. In the first part of the article, he questions this claimed essentiality of an authorial agent from three different angles: One concerning the border between diegetic and extradiegetic issues. Another with specific focus on unreliable simultaneous narration (first person......, present tense). And a third with attention paid to the role of unreliable narrators in factual narratives. In the article, he proposes a model for describing the different dynamic roles the authorial agent, as well as the empirical reader, plays in different forms of unreliable narration. Here, terms like...

Clinical profile of HIV infection

Directory of Open Access Journals (Sweden)

Khopkar Uday

1992-01-01

Full Text Available HIV seropositivity rate of 14 percent was observed amongst STD cases. Heterosexual contact with prostitutes was the main risk factor. Fever, anorexia, weight loss, lymphadenopathy and tuberculosis were useful clinical leads. Genital ulcers, especially chancroid, were common in seropositivies. Alopecia of unknown cause, atypical pyoderma, seborrhea, zoster, eruptive mollusca and sulfa-induced erythema multiforme were viewed with suspicion in high risk groups. Purpura fulminans, fulminant chancroid, vegetating pyoderma and angioedema with purpura were unique features noted in this study.

Organizational routines, innovation, and flexibility: the application of narrative networks to dynamic workflow.

Science.gov (United States)

Hayes, Gillian R; Lee, Charlotte P; Dourish, Paul

2011-08-01

The purpose of this paper is to demonstrate how current visual representations of organizational and technological processes do not fully account for the variability present in everyday practices. We further demonstrate how narrative networks can augment these representations to indicate potential areas for successful or problematic adoption of new technologies and potential needs for additional training. We conducted a qualitative study of the processes and routines at a major academic medical center slated to be supported by the development and installation of a new comprehensive HIT system. We used qualitative data collection techniques including observations of the activities to be supported by the new system and interviews with department heads, researchers, and both clinical and non-clinical staff. We conducted a narrative network analysis of these data by choosing exemplar processes to be modeled, selecting and analyzing narrative fragments, and developing visual representations of the interconnection of these narratives. Narrative networks enable us to view the variety of ways work has been and can be performed in practice, influencing our ability to design for innovation in use. Narrative networks are a means for analyzing and visualizing organizational routines in concert with more traditional requirements engineering, workflow modeling, and quality improvement outcome measurement. This type of analysis can support a deeper and more nuanced understanding of how and why certain routines continue to exist, change, or stop entirely. At the same time, it can illuminate areas in which adoption may be slow, more training or communication may be needed, and routines preferred by the leadership are subverted by routines preferred by the staff. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Narrative insight in psychosis: The relationship with spiritual and religious explanatory frameworks.

Science.gov (United States)

Marriott, Michael R; Thompson, Andrew R; Cockshutt, Graham; Rowse, Georgina

2018-03-25

When considering psychosis, the concept of narrative insight has been offered as an alternative to clinical insight in determining individuals' responses to their difficulties, as it allows for a more holistic and person-centred framework to be embraced within professional practice. This study aims to explore the validity of the narrative insight construct within a group of people who have experienced psychosis. Inductive qualitative methods were used to explore how eight participants utilized spiritual or religious explanatory frameworks for their experiences of psychosis and to consider these in relation to the construct of narrative insight. Semi-structured interviews were undertaken with individuals who identified themselves as interested in spiritual or religious ideas and whose self-reported experiences which were identified as akin to psychosis by experienced academic clinicians. Transcriptions from these interviews were subject to interpretative phenomenological analysis within a broader research question; a selection of themes and data from the resultant phenomenological structure are explored here for their relevance to narrative insight. Participants discussed spiritual and biological explanations for their experiences and were able to hold alternative potential explanations alongside each other. They were reflective regarding the origins of their explanations and would describe a process of testing and proof in relation to them. These findings suggest that the narrative insight construct has the potential to be a valid approach to understanding experiences of psychosis, and challenge the dominance of the clinical insight construct within clinical practice. Clinicians should value the explanatory framework for experiences which are provided by individuals experiencing psychosis, and encourage them to develop a framework which is coherent to their own world view rather than predominantly pursuing a biomedical explanation. Assessments of psychosis should

Negotiating competing discourses in narratives of midwifery leadership in the English NHS.

Science.gov (United States)

Divall, Bernie

2015-11-01

to explore midwifery leaders' narratives of identity, within the context of one region of England. a qualitative study using narrative identity theory. Data were collected using in-depth, loosely structured narrative interviews. the study was undertaken in the Midlands region of England, in the context of a midwifery-specific leadership development programme. Participants were located in local NHS organisations and higher education institutions. the interviewees were midwives currently in one of a variety of formal leadership roles, who had recently completed a midwifery leadership development programme. Nine leaders were interviewed for the study. two central themes emerged: 'I am still a midwife' showed interviewees' continued self-identification according to their professional identity, despite the majority no longer holding a clinical role; 'Between a rock and a hard place' showed the challenges of maintaining a professionally-based identity narrative in the face of group and organisational discourses. among the midwifery leaders interviewed, narratives centred on a continued midwife self-identification. However, participants faced a number of challenges in maintaining this narrative, within the context of wider professional group and organisational discourses. midwifery leaders require the support of their professional group and organisational structures if they are to maintain a positive self- and social-identity. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Standardized Narrative Profile Approach to Self-Reflection and Assessment of Cross-Cultural Communication

Directory of Open Access Journals (Sweden)

Kyle J Wilby

2017-03-01

Full Text Available Objectives: 1 to explore clinical assessor’s values regarding behaviours related to cultural aspects of care, 2 to generate standardized narrative profiles regarding cultural behavioural outcomes within clinical teaching settings, and 3 to rank order standardized narrative profiles according to performance expectations. Methods: Ten interviews were completed with clinicians to determine values and performance expectations for culturally competent behaviours. Transcripts were produced and coded. Six narrative profiles were developed based on data obtained. Twenty clinicians categorized profiles according to performance expectations and rank ordered. Intraclass correlation coefficients (ICCs determined inter-rater reliability. Clinicians rated usability of profiles in clinical training settings. Results: Eighteen categories were coded with communication, awareness and ability most frequently reported with each ranging from 9.6-11.5% of the utterances. Consensus for categorization of all profiles was achieved at a level of 70% (ICC = 0.837, 95% CI 0.654-0.969. High inter-rater reliability was achieved for rank ordering (ICC = 0.815, 95% CI 0.561 to 0.984. Seventeen (85% clinicians agreed that the profiles would be usable in clinical training settings. Conclusions: Standardized narrative profiles may aid assessment and self-reflection for student performance within culturally diverse interactions. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received, employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties.   Type: Original Research

Teaching about Narrative.

Science.gov (United States)

Davies, Gill

1978-01-01

Raises issues involved in the study and teaching of narrative, with reference to both literature and film. Considers the function of realism in narrative fiction and the teaching of theory and practice of those writers and filmmakers who have challenged the realist text by alternative strategies. (JMF)

Stories we tell one another: narrative reflection and the art of oncology.

Science.gov (United States)

Steensma, David P

2013-01-01

Storytelling is a deeply human act-ancient, universal, and familiar. But in this data-driven "Information Age," is there still room for narrative? As oncologists, we often feel overclocked, increasingly forced to microtask and live by the business world's mantra of "faster, cheaper, better," while our carefully honed humanistic clinical skills are coldly commoditized into Relative Value Units, our aptitude measured with tools that emphasize form over substance. In such an environment, can we still afford the inefficiency of anecdotes? Some might argue that we no longer need patient and physician narratives to inform care; instead, accurate molecular subtyping of tumors, good pharmaceutical agents, and rigorous clinical trial results are enough. Yet stories and reflections about being a doctor or being a patient remain important and instructive even in this era of molecular cancer medicine, even in the face of our increasing reliance on high-tech diagnostics and narrowly targeted smart therapeutics. Amid the pressures of rapidly changing practice patterns and the daily emotional challenges of working with seriously ill and dying patients, the acts of reflection and storytelling can also help keep us sane. Here I discuss the persistent importance of narrative in the context of the "Art of Oncology" forum of the Journal of Clinical Oncology.

Experiential narrative in game environments

OpenAIRE

Calleja, Gordon; Digital Games Research Association (DiGRA) 2009 Conference

2009-01-01

This paper explores the contentious notion of experiential narrative and proposes the first step in a narrative framework for game environment. It argues for a shift in emphasis from story-telling, the dominant mode of narrative in literature and cinema, to story generation. To this effect the paper forwards a perspective on experiential narrative that is grounded in the specific qualities of the game. This avoids the over-generalization that tends to accompany discussions of experiential nar...

A narrative analysis of a speech pathologist's work with Indigenous Australians with acquired communication disorders.

Science.gov (United States)

Hersh, Deborah; Armstrong, Elizabeth; Bourke, Noni

2015-01-01

To explore in detail the narrative of a speech pathologist (SP) working with Indigenous Australian clients with acquired communication disorders following stroke or brain injury. There is some evidence that Indigenous clients do not find speech pathology rehabilitation to be culturally appropriate but, currently, there is very little published on the nature of this service or the experiences of SPs who provide this rehabilitation. This research uses both thematic and structural narrative analysis of data from a semi-structured, in-depth interview with a SP to examine the adaptations that she made to address the needs of her adult neurological caseload of (mainly) Indigenous Australians from both urban and remote regions. The thematic analysis resulted in a core theme of flexibility and four other sub-themes: awareness of cultural context, client focus/person-centredness, being practical and working ethically. The structural narrative analysis allowed insight into the nature of clinical reasoning in a context lacking predictability and where previous clinical certainties required adaptation. Individual, detailed narratives are useful in exposing the challenges and clinical reasoning behind culturally sensitive practice. Implications for Rehabilitation Speech pathologists (SPs) can learn from hearing the clinical stories of colleagues with experience of providing rehabilitation in culturally diverse contexts, as well as from ongoing training in culturally competent and safe practices. Such stories help bridge understanding from the general to the particular. SPs working with Indigenous Australians with acquired communication disorders post-stroke and brain injury may find it helpful to consider how the themes, drawn from an interview with the clinician in this study - flexibility, awareness of cultural context, person-centredness, being practical and working ethically - might apply to their practice. Narratives may be helpful in staff training and form an important

Narrative therapy for adults with major depressive disorder: improved symptom and interpersonal outcomes.

Science.gov (United States)

Vromans, Lynette P; Schweitzer, Robert D

2011-01-01

This study investigated depressive symptom and interpersonal relatedness outcomes from eight sessions of manualized narrative therapy for 47 adults with major depressive disorder. Post-therapy, depressive symptom improvement (d=1.36) and proportions of clients achieving reliable improvement (74%), movement to the functional population (61%), and clinically significant improvement (53%) were comparable to benchmark research outcomes. Post-therapy interpersonal relatedness improvement (d=.62) was less substantial than for symptoms. Three-month follow-up found maintenance of symptom, but not interpersonal gains. Benchmarking and clinical significance analyses mitigated repeated measure design limitations, providing empirical evidence to support narrative therapy for adults with major depressive disorder.

Thickening Thin Narratives: A Feminist Narrative Conceptualization of Male Anorexia Nervosa

Directory of Open Access Journals (Sweden)

David King

2013-01-01

Full Text Available The purpose of this article is to conceptualize a feminist narrative approach to male anorexia nervosa (MAN. Both narrative and feminist theories have been utilized to enrich the discourse of AN among women. An unintended result of this primary focus on women’s experiences has been a limited focus on the experiences of men with AN. This article will explore a contemporary social discourse on masculinity, why some men utilize AN as a means of attaining the ideals put forth through such discourse, and how a feminist narrative approach can be applied to working with men struggling with AN.

Mural folliculitis and alopecia caused by infection with goat-associated malignant catarrhal fever virus in two sika deer.

Science.gov (United States)

Crawford, Timothy B; Li, Hong; Rosenburg, Stuart R; Norhausen, Robert W; Garner, Michael M

2002-09-15

Two sika deer from a zoo in Florida were examined because of chronic hair loss and skin lesions. No common causes of alopecia were identified in either deer. One deer was treated with prednisone, but the condition worsened when the dosage was decreased. Both deer were euthanatized after several months because of continued disease. The predominant histologic lesion in skin specimens was granulomatous mural folliculitis. Serologic testing and sequencing of fragments produced with a consensus polymerase chain reaction assay indicated that both deer were infected with caprine herpesvirus-2, a newly recognized member of the malignant catarrhal fever group of viruses. Disease in these deer was substantially different from that typically seen following infection with ovine herpesvirus-2, the sheep-associated malignant catarrhal fever virus. Findings in these deer establish the pathogenicity of caprine herpesvirus-2 in sika deer and illustrate the ability of this group of complex herpesviruses to cause a wide variety of clinical abnormalities in diverse species.

Divergent neural responses to narrative speech in disorders of consciousness.

Science.gov (United States)

Iotzov, Ivan; Fidali, Brian C; Petroni, Agustin; Conte, Mary M; Schiff, Nicholas D; Parra, Lucas C

2017-11-01

Clinical assessment of auditory attention in patients with disorders of consciousness is often limited by motor impairment. Here, we employ intersubject correlations among electroencephalography responses to naturalistic speech in order to assay auditory attention among patients and healthy controls. Electroencephalographic data were recorded from 20 subjects with disorders of consciousness and 14 healthy controls during of two narrative audio stimuli, presented both forwards and time-reversed. Intersubject correlation of evoked electroencephalography signals were calculated, comparing responses of both groups to those of the healthy control subjects. This analysis was performed blinded and subsequently compared to the diagnostic status of each patient based on the Coma Recovery Scale-Revised. Subjects with disorders of consciousness exhibit significantly lower intersubject correlation than healthy controls during narrative speech. Additionally, while healthy subjects had higher intersubject correlation values in forwards versus backwards presentation, neural responses did not vary significantly with the direction of playback in subjects with disorders of consciousness. Increased intersubject correlation values in the backward speech condition were noted with improving disorder of consciousness diagnosis, both in cross-sectional analysis and in a subset of patients with longitudinal data. Intersubject correlation of neural responses to narrative speech audition differentiates healthy controls from patients and appears to index clinical diagnoses in disorders of consciousness.

A randomized, active- and placebo-controlled study of the efficacy and safety of different doses of dutasteride versus placebo and finasteride in the treatment of male subjects with androgenetic alopecia.

Science.gov (United States)

Gubelin Harcha, Walter; Barboza Martínez, Julia; Tsai, Tsen-Fang; Katsuoka, Kensei; Kawashima, Makoto; Tsuboi, Ryoji; Barnes, Allison; Ferron-Brady, Geraldine; Chetty, Dushen

2014-03-01

Dihydrotestosterone is the main androgen causative of androgenetic alopecia, a psychologically and physically harmful condition warranting medical treatment. We sought to compare the efficacy and safety of dutasteride (type 1 and 2 5-alpha reductase inhibitor) with finasteride (type 2 5-alpha reductase inhibitor) and placebo in men with androgenetic alopecia. Men aged 20 to 50 years with androgenetic alopecia were randomized to receive dutasteride (0.02, 0.1, or 0.5 mg/d), finasteride (1 mg/d), or placebo for 24 weeks. The primary end point was hair count (2.54-cm diameter) at week 24. Other assessments included hair count (1.13-cm diameter) and width, photographic assessments (investigators and panel), change in stage, and health outcomes. In total, 917 men were randomized. Hair count and width increased dose dependently with dutasteride. Dutasteride 0.5 mg significantly increased hair count and width in a 2.54-cm diameter and improved hair growth (frontal view; panel photographic assessment) at week 24 compared with finasteride (P = .003, P = .004, and P = .002, respectively) and placebo (all P < .001). The number and severity of adverse events were similar among treatment groups. The study was limited to 24 weeks. Dutasteride increased hair growth and restoration in men with androgenetic alopecia and was relatively well tolerated. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Children's Cognitive and Affective Responses About a Narrative Versus a Non-Narrative Cartoon Designed for an Active Videogame.

Science.gov (United States)

Fernandes Davies, Vanessa; Mafra, Rafaella; Beltran, Alicia; Baranowski, Thomas; Lu, Amy Shirong

2016-04-01

This article presents the results of interviews conducted with children regarding their cognitive and affective responses toward a narrative and a non-narrative cartoon. The findings will be used to further explore the role of a narrative in motivating continued active videogame play. Twenty children (8-11 years old of mixed gender) watched two cartoons (narrative and non-narrative) and were subsequently interviewed. A thematic matrix was used to analyze the interviews. The narrative cartoon (n = 11) was only slightly preferred compared with the non-narrative one (n = 9), with little difference among the participants. The theme categories identified during the analyses were plot, characters, and suggestions. The fight scenes were mentioned by the children as a likeable aspect of the narrative cartoon. In the non-narrative cartoon, the vast majority (n = 17) liked the information about physical activity that was provided. The children enjoyed the appearance and personalities of the characters in both cartoons. A discrepancy in the data about the fight scenes (narrative cartoon) and characters (both cartoons) was found among the female participants (i.e., some girls did not like the fight and thought the characters were too aggressive). However, most of the children wanted to see more action in the story, an increase in the number of fight scenes (narrative cartoon), or more information about exercise and examples of exercises they could do (non-narrative cartoon). They also suggested adding a game to the non-narrative cartoon, including more characters, and improving the animation in both cartoons. The children preferred the narrative cartoon because of the story and the fight. Some gender differences were found, which further studies should investigate.

Narratives of suffering of South Asian immigrant survivors of domestic violence.

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Kallivayalil, Diya

2010-07-01

This article examines the narratives of suffering expressed by a group of South Asian immigrant survivors of domestic violence who accessed a mental health clinic in New York City. These accounts illustrate women's own perceptions of their suffering and symptoms and provide a window into the South Asian immigrant community's ideologies and moral domains regarding gender, violence, and sickness, as well as how individuals vary in their endorsement of these ideologies. The women's narratives illustrate how migration and culture interact with the deeply personal experience of suffering caused by domestic and sexual violence.

Clinical Evidence of Increase in Hair Growth and Decrease in Hair Loss without Adverse Reactions Promoted by the Commercial Lotion ECOHAIR®.

Science.gov (United States)

Alonso, María Rosario; Anesini, Claudia

2017-01-01

Hair exerts protection, sensory functions, thermoregulation, and sexual attractiveness. Hair loss (alopecia) is caused by several diseases, drug intake, hormone imbalance, stress, and infections (Malassesia furfur). Drugs usually used in alopecia produce irreversible systemic and local side effects. An association of extracts of Coffea arabica and Larrea divaricata (ECOHAIR®) is successfully being commercialized in Argentina for hair growth. The aim of this study was to provide scientific support for the efficacy and innocuousness of ECOHAIR® in patients with noncicatricial alopecia during a 3-month treatment. The efficacy was determined through the assessment of an increase in hair volume, improvement in hair looks, growth of new hair, and a decrease in hair loss by the test of hair count and hair traction. The capacity to decrease the amount of dandruff was also evaluated as well as the adverse local effects caused by the treatment. ECOHAIR® spray improved the overall hair volume and appearance; it increased its thickness, induced hair growth, and decreased hair loss. Besides, no adverse local reactions were observed upon treatment with the product. This study provides scientific support for the clinical use of ECOHAIR® as a treatment to be used in noncicatricial alopecia. © 2017 S. Karger AG, Basel.

"Cold" X5 Hairlaser™ used to treat male androgenic alopecia and hair growth: an uncontrolled pilot study.

Science.gov (United States)

Blum, Kenneth; Han, David; Madigan, Margaret A; Lohmann, Raquel; Braverman, Eric R

2014-02-24

Various trials have been conducted on the management and treatment of androgenic alopecia (AGA) or male pattern hair loss using a variety of laser and light sources. For this feasibility study, the population was composed of males between the ages of 20 and 60 years who have been experiencing active hair loss within the last 12 months and the diagnosis of AGA. They also had a Norwood-Hamilton classification of 3, 3A, 3 V, 4, 4A, or 5 for the hair thinning patterns and skin type I, II, III, or IV on the Fitzpatrick skin type scale. This two-arm randomized, parallel group study design employed stratifying randomization to balance treatment assignment within three investigational centers with at least 2 subjects enrolled in each Fitzpatrick skin type. A statistically significant positive trend in hair growth was observed from this pilot study, to evaluate the efficacy of the novel cold X5 hairlaser device for treating male androgenic alopecia. From the repeated measures analysis of variance, difference in mean hair counts over time was statistically significant (F = 7.70; p-value laser hair devices requires intensive further investigation. NCT02067260.

The clinical effect of JetpPeel-assisted topical minoxidil in the treatment of androgenetic alopecia: A randomized pilot study.