19043 research outputs found
Sort by
Combating “Dread Shed”: The Impact of Overlapping Topical and Oral Minoxidil on Temporary Hair Shedding During Oral Minoxidil Initiation
No full textBackground: Low dose oral minoxidil (LDOM) is a preferred treatment for alopecia due to ease of use and efficacy. While LDOM is typically well tolerated, patients may experience a temporary increase in hair shedding starting treatment, colloquially regarded as “dread shed”. One proposed method to combat this is to overlap therapies by maintaining use of topical minoxidil when initiating LDOM. Objective: To evaluate the impact of maintaining topical minoxidil when initiating LDOM on “dread shed”. Methods: We performed a retrospective chart review of patients seen at New York University Langone Health Dermatology from January 1, 2008 to August 1, 2023 prescribed LDOM. Results: A total of 115 patients met inclusion criteria, of whom 37 maintained use of topical minoxidil when initiating LDOM. Six patients experienced “dread shed” when initiating LDOM, 2 of whom overlapped therapies. We did not find that overlapping therapies had a significant impact on decreasing rates of “dread shed”. Limitations: Limitations include retrospective design, sample size, and subjective patient-reported assessment of hair shedding. Conclusions: A total of 5.2% of patients experienced dread shed, which is lower than previously reported in literature. Maintaining topical minoxidil during LDOM initiation does not significantly impact “dread shed”. This remains a significant side effect deserving of further research
Botanical Briefs: Contact Dermatitis Induced by Western Poison Ivy (Toxicodendron Rydbergii)
No full textProduct Warranties by Orthopaedic Surgery Companies. Quality Control or a New Fad?
No full textIntroduction: Product guarantees are known to the manufacturing industry, however warranties have been rare in Orthopaedic surgery. Over the last 10 years, select manufacturers of implants have instituted warranties of varying scope, length, and reimbursement. This phenomenon prompted us to investigate the landscape of warranties in Orthopaedics and compare that to other medical industries to better inform their impact on patient care. Methods: We conducted a systematic review of patient access material of over 120 Orthopaedic manufacturers including that of the Top 25 grossing companies of 2022 to identify the prevalence and scope of these warranties. Results: We identified eight companies that offer a warranty on implants. The expiration time for the implant warranties ranged from one year to lifetime. The scope of the warranties ranged from coverage of a one-time component replacement to outcome-based guarantees that cover any complications and revisions that may result from the surgery. Discussion: While the use of warranties remains uncommon in orthopaedics, their utility is expanding and evolving. Contemporary warranties appear to have a focus on enhancing product-marketability and improving quality-control
Single Long-Incision Minimally Invasive Surgery
No full textStudy Design. Retrospective cohort study. Objective. The objective of this study is to determine differences in outcomes in patients with adolescent idiopathic scoliosis undergoing spinal deformity correction surgery using a posterior spinal fusion (PSF) approach versus single and triple-incision minimally invasive surgery (MIS). Summary of Background Data. MIS increased in popularity as surgeons\u27 focus moved towards soft tissue preservation, but it carries technical demands and increased surgical time compared with PSF. Patients and Methods. Surgeries performed from 2016 to 2020 were included. Cohorts were formed based on surgical approach: PSF versus single long-incision MIS (SLIM) versus traditional MIS [3-incision MIS (3MIS)]. There were a total of 7 subanalyses. Demographic, radiographic, and perioperative data were collected for the 3 groups. Kruskal-Wallis and χ2tests were used for continuous and categorical variables, respectively. Results. Five hundred thirty-two patients met our inclusion criteria, 294 PSF, 179 3MIS, and 59 SLIM. Estimated blood loss (mL) (P \u3c 0.00001) and length of stay (LOS) (P \u3c 0.00001) was significantly higher in PSF than in SLIM and 3MIS. Surgical time was significantly higher in 3MIS than in PSF and SLIM (P = 0.0012). Patients who underwent PSF had significantly lower postoperative T5 to T12 kyphosis (P \u3c 0.00001) and percentage kyphosis change (P \u3c 0.00001). Morphine equivalence was significantly higher in the PSF group during total hospital stay (P = 0.0042). Patients who underwent SLIM and 3MIS were more likely to return to noncontact (P = 0.0096) and contact sports (P = 0.0095) within 6 months and reported lower pain scores (P \u3c 0.001) at 6 months postoperation. Conclusion. SLIM has a similar operative time to PSF and is technically similar to PSF while maintaining the surgical and postoperative outcome advantages of 3MIS
Assessing the Influence of Medications With Antagonistic Effects on Low-Dose Oral Minoxidil in Patients With Alopecia: A Retrospective Study
No full text
Improving Efficacy and Maintaining Safety in the Treatment of Alopecia With Low-Dose Oral Minoxidil and Spironolactone Combination Therapy: A Retrospective Review
No full textBrief Report: Differentiated Service Delivery Framework for People with Multidrug-Resistant Tuberculosis and HIV Coinfection
No full textThe Role of Phosphodiesterase 9A Inhibitors in Heart Failure
No full textIntroduction: There are currently limited effective treatments available to improve lusitropy in patients suffering from heart failure with preserved ejection fraction. The role of PDE9A in diastolic dysfunction has been well-studied over recent years, with a special focus on its association with myocardial hypertrophy. Recent insights into PDE9A inhibition have brought to light the potential for reversal of cardiac remodeling, with multiple studies showing promising results in preclinical data. Areas covered: This expert opinion provides an overview of the role of PDE9A in diastolic heart dysfunction along with the efficacy of PDE9A inhibitors in laboratory models of heart failure with preserved ejection fraction. Expert opinion: The available data on PDE9A inhibition in preclinical studies suggest that there is potential for reversal of diastolic dysfunction and myocardial hypertrophy, however, conflicting data suggests that further studies are required before progressing to clinical trials
Recovery From Left Ventricular Dysfunction
No full textThe treatment of heart failure is an evolving field of cardiology, with increasingly available therapeutics and significant disease burden. With the effective treatments available, we see a substantial patient population whose once reduced ejection fraction (EF) has normalized. Studies have assessed the natural history of these patients with improved EF and found improved mortality as compared with those patients with persistently reduced EF, with some evidence stating that each 5% increase in left ventricular EF correlates with a 4.9-fold decrease in the odds of mortality. This prognostic divergence has led to the recognition of this subset of patients as having a unique heart failure diagnosis, distinct from heart failure with reduced EF (HFrEF) or heart failure with preserved EF and to the adoption of the term heart failure with recovered EF. These patients, despite having improved mortality, do retain some of the molecular and histologic changes seen in HFrEF and are still at risk for decline in left ventricular function and adverse cardiac events, particularly when medical therapy is stopped. This distinction between recovery of EF and true myocardial recovery led to recent guidelines recommending continuation of guideline-directed medical therapy indefinitely, as well as surveillance echocardiography