Biomedical subjects

Nowell Solish

Publications and source records attributed to Nowell Solish.

11 recordsLinked to original sources

PubMed2006

Multicenter study of the efficacy and safety of subcutaneous non-animal-stabilized hyaluronic acid in aesthetic facial contouring: interim report.

BACKGROUND: Non-animal-stabilized hyaluronic acid (NASHA) gel may offer longer-lasting cosmetic correction and lower antigenic risk than other soft tissue augmentation agents. OBJECTIVE: To assess the efficacy and safety of the NASHA gel Restylane SubQ (Q-Med AB, Uppsala, Sweden) in aesthetic facial contouring. METHODS: Fifty-seven adult patients seeking cheek and/or chin augmentation received subcutaneous and/or supraperiostal injections of Restylane SubQ (20 mg/mL) at 114 treatment sites; 13 of these patients received "touch-up" injections at 20 sites. Efficacy was assessed subjectively using a 5-grade Global Aesthetic Improvement Scale at 1, 3, 6, 9, and 12 months after the initial treatment. RESULTS: At 3 months post-baseline, patients and investigators independently considered the treatment sites to be improved in 96.4% and 100% of cases, respectively. Patient- and investigator-assessed response rates (proportion of patients showing moderate or better improvement) were 84% and 95%, respectively. The majority of reported adverse events were treatment related (local injection-site reactions, implantation complications, skin tightness, and skin induration), but these were generally of mild intensity and short-lived. CONCLUSION: Restylane SubQ is well tolerated and maintains aesthetic correction of the cheeks and chin for at least 3 months after subcutaneous and/or supraperiostal treatment.

Adult↗

PubMed2005

Microarray profiles of human basal cell carcinoma: insights into tumor growth and behavior.

PURPOSE: Basal cell carcinoma (BCC) is the most common human neoplasm. Much interest lies in determining the genetic basis of BCC to explain the unique locally invasive phenotype and infrequent metastatic behavior of these skin tumors. OBJECTIVE: We sought to examine a gene expression profile for BCC to elucidate new molecules responsible for its unique growth characteristics. METHODS: We analyzed gene expression patterns of 50 BCC tumors using spotted cDNA microarrays of 1718 characterized human genes related to cancer and immunity. This is the largest and most comprehensive gene expression study ever performed for BCC. Nodular and sclerosing histological subtypes of BCC were examined and compared to normal control skin. After statistical filtering, 374 significantly dysregulated genes were sorted by hierarchical clustering to determine trends of gene expression and similarities between patient gene expression profiles. RESULTS: A total of 165 upregulated genes and 115 downregulated genes were identified. These covered a range of categories, including extracellular matrix, cell junctions, motility, metastasis, oncogenes, tumor suppressors, DNA repair, cell cycle, immune regulation and angiogenesis. Clusters of genes were either commonly dysregulated across the 50 patient sample, or selectively affected in subsets of tumors. Histological subtypes were not distinguishable by hierarchical clustering. Many of the genes elucidated, including collagen type IV subunits and other novel candidates, possess functions related to extracellular matrix remodeling and metastasis. CONCLUSION: These results suggest a gene profile which may explain the invasive growth yet rarely metastatic behavior of BCC. The genes identified may also be potential targets for therapeutics aimed at further controlling invasiveness and local destruction of BCC.

Basal Cell Carcinoma↗

PubMed2005

Focal hyperhidrosis: diagnosis and management.

Hyperhidrosis, a condition characterized by excessive sweating, can be generalized or focal. Generalized hyperhidrosis involves the entire body and is usually part of an underlying condition, most often an infectious, endocrine or neurologic disorder. Focal hyperhidrosis is idiopathic, occurring in otherwise healthy people. It affects 1 or more body areas, most often the palms, armpits, soles or face. Almost 3% of the general population, largely people aged between 25 and 64 years, experience hyperhidrosis. The condition carries a substantial psychological and social burden, since it interferes with daily activities. However, patients rarely seek a physician's help because many are unaware that they have a treatable medical disorder. Early detection and management of hyperhidrosis can significantly improve a patient's quality of life. There are various topical, systemic, surgical and nonsurgical treatments available with efficacy rates greater than 90%-95%.

Administration, Topical↗

PubMed2005

Use of hyaluronic acid for soft tissue augmentation of HIV-associated facial lipodystrophy.

BACKGROUND: Lipodystrophy syndrome is a devastating complication of antiretroviral therapy in individuals with human immunodeficiency virus (HIV). The appearance of the associated facial lipoatrophy can be demoralizing and stigmatizing for the affected individuals to a point at which it may compromise their compliance with antiretroviral medication. OBJECTIVE: We describe the use of hyaluronic acid as an intradermal filler for correction of this disfiguring problem. METHODS: We treated five patients with grade 2 to 3 facial lipoatrophy. Each patient received approximately 5 to 6 cc in total of hyaluronic acid in the malar area via intradermal injection. RESULTS: There were no adverse events. We found that this technique provided a good cosmetic result with high patient satisfaction. At 6-month follow-up, sustained longevity was observed. CONCLUSIONS: We propose the use of hyaluronic acid for HIV-associated facial lipoatrophy as an efficacious and safe, but temporary, option for this problem until a more cost-effective option is available.

Adult↗

PubMed2005

Prospective open-label study of botulinum toxin type A in patients with axillary hyperhidrosis: effects on functional impairment and quality of life.

BACKGROUND: Patients with primary axillary hyperhidrosis experience substantial functional impairment and reduced health-related quality of life (HRQOL). Few studies have comprehensively evaluated the effects of botulinum toxin type A (BoNT-A) on these symptoms. OBJECTIVE: To prospectively assess the effects of BoNT-A on functional impairment associated with primary axillary hyperhidrosis. METHODS: Patients treated with BoNT-A 50 U per axilla at baseline were assessed 4 and 12 weeks later. Outcome measures included functional impairment as assessed by the Hyperhidrosis Disease Severity Scale and the Hyperhidrosis Impact Questionnaire and dermatology-specific HRQOL as assessed by the Dermatology Life Quality Index. RESULTS: At weeks 4 and 12 after BoNT-A treatment, 85% and 90% of patients achieved the a priori definition of treatment responder. Patients reported less occupational and emotional impairment, spent less time managing their hyperhidrosis, and had fewer difficulties in social situations. Adverse events were uncommon (5.5%), were mild, and did not require treatment. At study end, 53% of patients reported no dermatology-specific HRQOL impairment and 90% were satisfied with treatment. CONCLUSIONS: Significant, meaningful, rapid, and durable reductions in disease severity and functional impairment, as well as improvements in HRQOL, were seen following BoNT-A treatment. BoNT-A was safe and well tolerated, producing high levels of patient satisfaction.

Adolescent↗

PubMed2004

Hyperhidrosis: an approach to diagnosis and management.

Hyperhidrosis is defined as focal or generalized excessive sweating with a prevalence of 2.8% of the general population. This medical condition is associated with significant psychosocial morbidity and has a dramatic impact on activities of daily living. A significant proportion of patients do not consult a physician for this condition. Early diagnosis is essential in order to implement management strategies that have excellent efficacy rates and patient satisfaction.

Humans↗

PubMed2003

Treatment of hyperhidrosis with botulinum toxin.

Focal hyperhidrosis is a common problem that affects up to 2.8% of the population with significant psychosocial implications. Traditional therapies have not proven effective for most of these patients, which further adds to patient anxiety. Botulinum toxin is emerging as a novel treatment for focal hyperhidrosis and is proving to be safe and effective. A therapeutic protocol for focal hyperhidrosis includes an individualized treatment plan for each site of involvement. For those who are affected in the palms and soles, the most common treatments include topical treatment with aluminum chloride, iontophoresis, botulinum toxin,systemic medications, and sympathectomy. For those who have axillary focal hyperhidrosis, iontophoresis is often difficult and botulinum toxin becomes the second line therapy. As of June 2003, BTX A has been approved for the treatment of hyperhidrosis in 13 countries: England, Canada, New Zealand, Australia, Taiwan, Netherlands, Switzerland, Brazil, Argentina, Columbia, El Salvador, Guatemala, and Mexico. With the currently available literature and ongoing studies, it should only be a short time before the U.S. Food and Drug Administration approves botulinum toxin therapy for focal hyperhidrosis in the United States.

Botulinum Toxins, Type A↗

PubMed2003

Metallic taste: an unusual reaction to botulinum toxin A.

BACKGROUND: Botulinum neurotoxin formulations are safe and effective agents for the treatment of facial rhytides. OBJECTIVES: A patient is described who complained of metallic taste after each treatment with botulinum toxin A (BTX-A). RESULTS: The sensation of metallic taste diminished after successive treatments with BTX-A, despite adequate dosing for cosmetic purposes. CONCLUSION: Metallic taste is associated with the use of numerous medications; however, the pathogenesis remains unclear. Alteration in zinc metabolism, which may occur with BTX-A administration, has been suggested as a possible mechanism. Although this is the first known report of dysgeusia after BTX-A, physicians and patients may be reassured that the taste alteration was self-limited and was not significantly problematic for the patient in our case.

Adult↗

PubMed2003

Effectiveness of dermasanding (manual dermabrasion) on the appearance of surgical scars: a prospective, randomized, blinded study.

BACKGROUND: Dermasanding using sterile sandpaper has been described as a simple treatment for scars but has not been evaluated in a prospective randomized fashion. It could provide a safe, simple, and cost-effective option for the treatment of scars. OBJECTIVE: Our purpose was to assess the effectiveness of dermasanding on the appearance of surgical scars of the face. METHODS: We evaluated 15 patients using a blinded, split-scar model. Each scar was divided into 2 equal portions, and half of the scar was treated according to randomized assignment. Scars were treated with dermasanding 6 to 8 weeks after operation. The treatment half was compared with the control half by blinded observers at 3 time points. RESULTS: Improvement in the treated half of scars was seen in 80% of patients at 6 months (95% confidence interval, 60%-100%), and 47% had an excellent response. In 20% of patients the unsanded side was better. CONCLUSIONS: Dermasanding is an effective procedure in the treatment of surgical scars.

Aged↗

PubMed2002

Long-term efficacy and quality of life in the treatment of focal hyperhidrosis with botulinum toxin A.

BACKGROUND: Botulinum toxin A has been used increasingly in the treatment of focal hyperhidrosis. OBJECTIVE: To assess the long-term efficacy of botulinum toxin A in the treatment of hyperhidrosis and the changes in quality of life and patient satisfaction with treatment. METHODS: A questionnaire was designed to assess the efficacy using visual analog scales and the quality of life both before and after treatment using a modified Dermatology Life Quality Index scale. RESULTS: There was a reduction in the hyperhidrosis and a statistically significant improvement in the quality of life scores for the axillae, palms, and forehead. CONCLUSION: Botulinum toxin A injections are safe and effective for the treatment of hyperhidrosis of the axillae, palms, and forehead, resulting in an improved quality of life for patients.

Botulinum Toxins, Type A↗

PubMedDate not supplied

Characterizing anxiety in melanoma patients.

BACKGROUND: Over half of melanoma patients experience significantly elevated anxiety levels leading to psychological distress and delays in diagnosis and treatment. OBJECTIVE: To identify melanoma patients likely to experience high levels of anxiety, we characterize the contributing factors and coping strategies and investigated potential anxiety-alleviating interventions. METHOD: Surveys were sent to 94 melanoma patients at Women's College Hospital's Pigmented Lesion Clinic assessing self-reported anxiety, contributing factors, coping strategies, and potential assisting services. RESULTS: Risk factors for anxiety include female gender (p=0.002) and increasing age (p=0.004) but not melanoma depth. Major factors contributing to anxiety are prognosis, fear of death, and the attitude of the diagnosing doctor. Major coping strategies include family support, doctor assistance, and self-distraction. Potentially useful services for decreasing anxiety include the provision of detailed information pamphlets. CONCLUSION: Melanoma patients likely to experience high anxiety can be predicted and managed in ways that minimize the distress experienced.

Adaptation, Psychological↗