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Biomedical subjects

Jaggi Rao

Publications and source records attributed to Jaggi Rao.

17 recordsLinked to original sources
PubMed2006

Improvement in the appearance of wrinkles with topical transforming growth factor beta(1) and l-ascorbic acid.

BACKGROUND AND OBJECTIVE: Facial rhytides are a common cosmetic concern. Surgical treatment effects dramatic improvement; however, the associated risk and cost may be prohibitive. Recent focus is on developing topical products containing biologically active ingredients for at-home therapy. Our study examines the effects of a topical cream containing transforming growth factor-beta(1) (TGF-beta(1)), l-ascorbic acid, and Cimicifuga racemosa extract (CRS) (Topix Pharmaceuticals, North Amityville, NY, USA). MATERIALS AND METHODS: In the first arm of the study, 12 subjects were randomized to apply CRS to the left or right side of their face and a cream containing l-ascorbic acid and C. racemosa in silicone base (vitamin C [Vit C]) to the contralateral side twice daily for 3 months. In the second arm of the study, 20 subjects were randomized to apply CRS to the left or right side of their face and Tissue Nutrient Solution Recovery Complex (TNS) (SkinMedica, Carlsbad, CA, USA), a product containing a variety of growth factors including VEGF, PDGF-A, G-CSF, HGF, IL-6, IL-8, and TGF-beta(1) (Nouricel-MD) without l-ascorbic acid, C. racemosa extract, or silicone base, to the contralateral side of their face twice daily for 3 months. Digital photographs were scored by study-blinded physicians, and self-assessments were completed by all subjects at baseline and at the conclusion of the protocol. RESULTS: CRS and TNS were well tolerated, and all subjects completed the 3-month protocol for the CRS versus Vit C arm of the study. Physicians rated success in facial wrinkling scores on the CRS-treated side of the face for 27 of 31 subjects. Responders showed, on average, 21.7% improvement in physician-rated wrinkle scores. The mean improvement in the group of 31 patients as a whole was 12%. Eighteen of 31 subjects reported a noticeable improvement on their CRS-treated side. Both CRS and TNS demonstrate significant success between baseline and 3-month scores, and both growth factor products are superior to Vit C. Patients preferred CRS over TNS. CONCLUSION: CRS is effective in minimizing the appearance of facial rhytides. The success of the CRS product is largely attributable to the incorporation of TGF-beta(1).

Adult↗
PubMed2005

Stability of foam in sclerotherapy: differences between sodium tetradecyl sulfate and polidocanol and the type of connector used in the double-syringe system technique.

BACKGROUND: Foam sclerotherapy is an increasingly popular modality in the treatment of varicose veins. Worldwide, the most popular agents used are sodium tetradecyl sulfate (STS) and polidocanol (POL). The double-syringe system technique to make foam out of a sclerosing solution and air has received wide attention for its ease and reproducibility. This study examined the possibility that the relative silicone content of various disposable connectors may affect overall foam stability. We also evaluated the differences in the stability of foam between STS and POL. MATERIALS AND METHODS: In the first part of the study, one nondisposable stainless steel connector and five disposable plastic connectors were used to create foam from STS 0.50% and air. The procedure was then repeated to produce foam from POL 0.50% and air from each of the six different connector types. As a measure of foam stability, once foam was created with each type of connector, the time required for half of the original volume of sclerosing solution to settle was recorded. In the second part of the study, foam was created with a nondisposable stainless steel connector only and various concentrations of STS and POL. Foam stability was then measured for these different concentrations of sclerosants. RESULTS: The time for sclerosing solution to settle to half of its initial volume was found to vary according to the specific sclerosant and concentration used, with no statistically significant variation based on connector type. CONCLUSIONS: The type of connector used in the double-syringe system technique to produce foam for sclerotherapy is not a factor in foam stability. Sclerosing solutions differ in their foaming stability.

Dosage Forms↗
PubMed2005

Treatment of local, persistent cutaneous atrophy following corticosteroid injection with normal saline infiltration.

BACKGROUND: Injections of corticosteroids are commonly used for a variety a dermatologic conditions but may cause local, persistent cutaneous atrophy, with few therapeutic options. OBJECTIVE: To determine the effectiveness of bacteriostatic normal saline infiltration on the improvement of corticosteroid-induced cutaneous atrophy. MATERIALS AND METHODS: Four patients with corticosteroid-induced atrophy of the skin, two caused by acneiform cysts and one from intramuscular steroid injection, were treated with weekly injections of normal saline directly into the atrophic site. The patients were seen on weekly follow-up visits, and improvement was documented. RESULTS: All four patients demonstrated complete resolution of skin atrophy and restoration of surface contour within 4 to 8 weeks of initial presentation. Injected volumes of normal saline ranged from 5 to 20 cm(3) per treatment session and three to six weekly treatments. The patients were completely satisfied with these results. CONCLUSION: Normal saline infiltration offers a safe, tolerable, relatively rapid, and effective treatment for local, persistent corticosteroid-induced atrophy.

Adrenal Cortex Hormones↗
PubMed2005

Double-blind prospective comparative trial between foamed and liquid polidocanol and sodium tetradecyl sulfate in the treatment of varicose and telangiectatic leg veins.

BACKGROUND: Twenty subjects were treated with either polidocanol (POL) or sodium tetradecyl sulfate (STS) to compare the efficacy and adverse sequelae of each agent. OBJECTIVE: To determine the safety and efficacy of two widely used sclerosing agents. METHODS: After the exclusion of saphenofemoral junction incompetency, each subject's leg veins were categorized by size (< 1, 1-3, and 3-6 mm in diameter). Each leg was then randomized to be treated with 0.5%, 1%, or 1% foam of POL or 0.25%, 0.5%, or 0.5% foam of STS according to vein size. An independent panel of four physicians, blinded to treatment, performed randomized photographic evaluations obtained pretreatment and 12 weeks post-treatment. Subject satisfaction index and overall clinical improvement assessment were also obtained. RESULTS: An average 83% improvement was noted for all vein sizes in all subjects with both POL and STS after a single treatment. Subjects were satisfied with treatment, regardless of the sclerosing agent used or the vein size treated. There was no statistically significant difference in adverse effects between each group. CONCLUSION: Both POL and STS are safe and effective sclerosing agents in the treatment of varicose and telangiectatic leg veins. Both are very tolerable and demonstrate similar post-treatment sequelae.

Double-Blind Method↗
PubMed2005

Clinical comparison between two hyaluronic acid-derived fillers in the treatment of nasolabial folds: hylaform versus restylane.

BACKGROUND: Hyaluronic acid-derived injectible fillers are ideal to reduce the appearance of nasolabial folding because their effect is relatively long-lasting, the material is malleable and easy to use, and there is a very low incidence of allergic reaction. OBJECTIVE: To compare the tolerability and efficacy of two commercially available hyaluronic acid-based fillers, Hylaform (INAMED Aesthetics, Inc., Santa Barbara, CA, USA) and Restylane (Medicis Pharmaceutical Corporation, Scottsdale, AZ, USA), in the treatment of nasolabial folds. METHODS: Eight healthy adult female subjects underwent filler injection therapy for tissue augmentation of their nasolabial folds. Each subject was randomized to receive Restylane 0.7 mL to either the right or the left nasolabial fold and Hylaform 1.0 mL to the contralateral side. High-quality digital photography was performed both at baseline and at 12 weeks post-treatment. These photographs were assessed by four blinded, independent dermatologist reviewers for improvement. Subjects completed questionnaires to document tolerability and satisfaction. RESULTS: All subjects found the procedure to be tolerable and completely pain free after the use of oral infraorbital regional anesthesia blocks. The average subject satisfaction score was 3.00 of 5 for Hylaform and 3.78 of 5 for Restylane. The blinded, independent reviewer panel attributed an average improvement score of 2.86 of 5 for Hylaform and 3.78 of 5 for Restylane. CONCLUSION: Both Hylaform and Restylane are effective fillers for tissue augmentation of the nasolabial folds. Restylane demonstrated higher efficacy and subject satisfaction than Hylaform. With regional nerve blocks prior to injection, both agents are completely painless.

Adult↗
PubMed2005

Prospective, comparative evaluation of three laser systems used individually and in combination for axillary hair removal.

BACKGROUND: Using the concept of selective photothermolysis, a variety of laser systems have been developed to remove unwanted hair. OBJECTIVE: To evaluate the relative efficacy, tolerability, and subject satisfaction of three different laser systems used individually and in rotation for axillary hair removal. METHODS: Twenty female patients (17 with dark-colored hair, 3 with red or light-colored hair) with Fitzpatrick phototype II skin received three treatments performed at 6- to 8-week intervals. Each axilla was divided in half to yield four distinct areas that were treated by the following lasers: (1) three sessions with a long-pulse 755 nm alexandrite laser, (2) three sessions with a long-pulse 810 nm diode laser, (3) three sessions with a long-pulse 1,064 nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser, and (4) rotational treatment consisting of a single session by each of the three laser systems. Percent hair reduction and acute and long-term side effects were evaluated after treatment. Subjects completed questionnaires assessing tolerability and satisfaction. RESULTS: All subjects tolerated the treatments well, with only local, transient side effects seen. At the 3-month follow-up, the greatest average hair reduction was comparably similarly seen after the alexandrite laser at 59.3 +/- 9.7% and the 810 nm diode laser at 58.7 +/- 7.7%. The Nd:YAG laser and rotational regimens were less efficacious, with 31.9 +/- 11.1% and 39.8 +/- 10.1% hair reduction, respectively. Subjects with red or light-colored hair experienced 5 to 15% reduced efficacy with any laser system used. Subjects found the alexandrite and diode lasers to be equally tolerable, with only slight discomfort, and the Nd:YAG laser to be the least comfortable of the three systems. Overall, subject satisfaction of each treated site, in decreasing order, was (1) the 810 nm diode laser, (2) the alexandrite laser, (3) rotational therapy, and (4) the Nd:YAG laser. CONCLUSION: At the 3-month follow-up, the long-pulse alexandrite and 810 nm diode lasers demonstrated no statistically significant differences in efficacy, comparable efficacy and tolerability, and highest subject satisfaction. Rotational therapy with the three laser systems is not as effective as treatment with the alexandrite laser or diode laser alone but is statistically more effective than use of the long-pulse Nd:YAG system alone. Individuals with red or light-colored hair and Fitzpatrick phototype II skin have decreased efficacy of laser treatment than those with dark-colored hair and the same phototype.

Adult↗
PubMed2004

Use of the Q-switched 755-nm alexandrite laser to treat recalcitrant pigment after depigmentation therapy for vitiligo.

BACKGROUND: In patients with extensive vitiligo, depigmentation therapy is often preferred over attempts to restore skin color. Bleaching creams sometimes fail to permanently depigment the skin, leaving disfiguring pigmented patches. This recalcitrant pigmentation may be treated with Q-switched laser technology. OBJECTIVE: The objective was use the Q-switched alexandrite laser to treat recalcitrant pigmentation after unsuccessful attempts at total-body depigmentation for vitiligo. METHODS: We have attempted to destroy the remaining melanin pigmentation in a 68-year-old woman with vitiligo by using selective photothermolysis from a Q-switched alexandrite laser. RESULTS: Excellent results were achieved after 10 treatment sessions, with no recurrence of pigment after 1 year of follow-up. CONCLUSION: The Q-switched alexandrite laser was used successfully and safely in a vitiligo patient with recalcitrant pigmentation after unsuccessful depigmentation therapy and may prove useful in other such cases.

Aged↗
PubMed2004

Intravascular 1320-nm laser closure of the great saphenous vein: a 6- to 12-month follow-up study.

OBJECTIVE: The objective was to determine the safety and efficacy of an intravascular laser with a novel wavelength to close the great saphenous vein. METHODS: Twenty-four cases of an incompetent great saphenous vein (0.5-1.2 cm in diameter) associated with distal varicose veins were treated with a 1320-nm intravascular laser at 5 W with an automatic pullback mechanism at 1 mm/s. Patients were evaluated with duplex ultrasound to determine efficacy of treatment at various time periods to at least 6 months after the procedure. RESULTS: All patients demonstrated complete closure of the incompetent great saphenous vein. In most cases, the treated great saphenous vein was not identifiable 6 months postoperatively. There was no recurrence of any varicose veins. All preoperative symptoms resolved after treatment, and no complications were noted. All patients were very pleased with the outcome of the procedure. CONCLUSIONS: At 6 months or greater follow-up, a 5-W, 1320-nm intravascular laser with 1 mm/s automatic pullback, delivered through a diffusion-tip fiber, is safe and effective in treating an incompetent great saphenous vein up to 1.2 cm in diameter.

Adult↗
PubMed2003

Algorithm for using a long-pulsed Nd:YAG laser in the treatment of deep cutaneous vascular lesions.

BACKGROUND: Conventional therapies for deep cutaneous vascular anomalies have demonstrated poor efficacy and many side effects. New laser systems offer greater potential to treat these difficult lesions, but the lack of specific treatment guidelines has restricted consistent success. OBJECTIVE: To establish a rational, user-friendly algorithm that incorporates basic components of deep vascular lesions to define the correct laser settings required for safe, effective, and reproducible treatment. METHODS: Within 18 months, 162 deep vascular lesions of various types and anatomic sites were evaluated for vessel size, depth, color, and pressure. An algorithm incorporating these characteristics was employed to determine laser parameter settings. Using a high-peak power, long-pulse 1064-nm Nd:YAG laser system, the vascular lesions were then treated. RESULTS: Within 6 months of follow-up, 80% of treated areas demonstrated a 50% or greater resolution after a single treatment session, with complete clearance shown in 19%. Only minimal and transient side effects were observed. Of note, 74% of areas on the extremities and 83% within the oral cavity showed a 50% or greater resolution after one treatment. CONCLUSION: Previously challenging deep cutaneous vascular anomalies may be safely reduced or cleared with the use of an appropriate laser system and this algorithm-directed technique. This represents a significant breakthrough in the management of vascular lesions.

Adolescent↗
PubMed2003

Cutaneous angiosarcoma as a delayed complication of radiation therapy for carcinoma of the breast.

Three cases of cutaneous angiosarcoma of the breast that arose in irradiated skin tissue in women who had previously undergone treatment for breast carcinoma are reported. A review of the literature identified 55 cases of cutaneous angiosarcoma following radiation therapy as part of the treatment of carcinoma of the breast. For all 58 assembled cases, the mean age at the time of adjuvant radiation therapy for breast carcinoma was 64 years (range 42-83). The mean time to subsequent diagnosis in irradiated skin was 75 months (range 12-192). The estimated 3-year overall survival for all 58 patients was only 20%, similar to that of patients with the general form of angiosarcoma. Postirradiation angiosarcoma of the breast has a variety of presentations; thus diagnosis is often delayed. Early diagnosis relies on a high index of suspicion and appropriate histopathologic studies, as the clinical and histopathologic findings may be confused with other conditions. Treatment should be aggressive and include local surgery with consideration of adjuvant systemic chemotherapy.

Breast Neoplasms↗
PubMed2002

Atypical mycobacterial infection following blepharoplasty and full-face skin resurfacing with CO2 laser.

BACKGROUND: With the popularity of laser skin resurfacing for the correction of photoaging and the improvement of acne scarring, it is important to note complications that may result from this procedure. Infections must be recognized and treated early, as some can result in permanent local destruction and systemic spread to other body sites. OBJECTIVE: To increase the awareness of an unusual infection that may result from laser resurfacing. METHODS: We report the case of a 52-year-old woman who presented with two symmetrical nodules 1 month after full-face skin resurfacing with CO2 laser. These were found to be abscesses caused by Mycobacterium fortuitum infection. RESULTS: The diagnosis was established following surgical debridement and subsequent culture grown from the exudate. Oral antibiotic treatment guided by organism sensitivity resulted in complete clearance of the infection with no recurrence or sequelae after 3 years of follow-up. CONCLUSION: This case demonstrates that atypical mycobacterial infections may arise after laser resurfacing procedures, despite proper technique, sterile instrumentation, and appropriate perioperative medications and postoperative wound care. If diagnosed and treated early, this potentially disastrous complication can be cured with no permanent sequelae.

Anti-Infective Agents↗
PubMedDate not supplied

Multiple keratoacanthomas arising post-UVB therapy.

BACKGROUND: Ultraviolet (UV) radiation is known to be an important etiologic agent in the development of skin cancer. Keratoacanthoma is an unusual, well-described cutaneous neoplasm that resembles squamous cell carcinoma but spontaneously resolves. Rarely, multiple keratoacanthomas may develop. OBJECTIVE: We present a case of multiple keratoacanthomas in a patient with psoriasis who had received UVB phototherapy. These lesions were hyperkeratotic papules, many of which spontaneously resolved and demonstrated the histologic characteristics of keratoacanthoma. CONCLUSION: We believe that UV radiation is the most likely etiologic factor in this patient's development of multiple keratoacanthomas. We wish to bring to the attention of clinicians this unusual adverse effect of UV treatment.

Aged↗
PubMedDate not supplied

The harlequin color change and association with prostaglandin E1.

The harlequin color change is an unusual cutaneous phenomenon observed in newborn infants as transient, benign episodes of a sharply demarcated erythema on half of the infant, with simultaneous contralateral blanching. In this report, two newborns with congenital heart anomalies demonstrated the harlequin color change, one whose skin findings showed a course related to the dose of systemic prostaglandin E1, suggesting a possible association. The benign, self-limited nature of the color change mandates that prostaglandin E1 not be discontinued for this reason. The entity is likely more common than the paucity of reports in the world literature suggests, and all physicians should recognize its graphic appearance to avoid unnecessary exposure to agents in an effort to treat it.

Alprostadil↗
PubMedDate not supplied

A double-blinded randomized trial testing the tolerability and efficacy of a novel topical agent with and without occlusion for the treatment of cellulite: a study and review of the literature.

Cellulite is the unsightly dimpling and nodularity frequently found on the thighs and buttocks of post-adolescent women. The anatomy and pathophysiology of this unwanted condition is poorly understood. The paucity of research studies to date has led to a dormancy of scientifically based therapeutic options that are effective and tolerable. The purpose of this study is to evaluate the tolerability and efficacy of a novel topical agent based on a plausible pathophysiologic mechanism in the treatment of cellulite, and to compare the efficacy of this agent used in combination with an occlusive bioceramic-coated neoprene garment, to the agent used alone without occlusion. We will also review the current understanding of the etiology and nature of cellulite and summarize available treatment options. Twenty women with a moderate degree of cellulite were entered into a four-week, double-blinded, randomized trial where an anti-cellulite cream was applied to the affected sites on a nightly basis. Each subject was randomized to receive occlusion by a bioceramic-coated neoprene garment on either the right or left leg, with the contralateral side serving as a control with no occlusion. High-quality digital photography was taken before treatment and after four weeks at various angles, with tangential full-spectrum lighting. Four blinded, independent dermatologist reviewers assessed the photographs for improvement. Subjects completed questionnaire forms to assess tolerability and efficacy. Of the 17 subjects who completed the study, 76% noticed an overall improvement in their cellulite, with 54% reporting greater improvement in the thigh that received garment occlusion. The average measured decrease in thigh circumference was 1.2 cm, noting a 1.3 cm reduction with occlusion and a 1.1 cm reduction without occlusion. Upon review of the pre- and post-study photographs, the dermatologist evaluators found an improvement in 65% of treated legs with occlusion, and 59% of treated legs without occlusion. Further, the evaluators found the occluded thighs to show greater improvement than the non-occluded thighs in 65% of subjects. The topical agent used in this study was found to be effective in reducing the appearance of cellulite. Bioceramic-coated neoprene garment occlusion potentiates the effect of this topical agent in cellulite reduction. The success of this study validates the pathophysiologic mechanism used to formulate the topical agent used.

Adipose Tissue↗
PubMedDate not supplied

A multicenter clinical evaluation of the treatment of mild to moderate inflammatory acne vulgaris of the face with visible blue light in comparison to topical 1% clindamycin antibiotic solution.

BACKGROUND: Blue light sources have been shown to be effective in the treatment of mild to moderate inflammatory acne vulgaris lesions. OBJECTIVE: We evaluated the safety and efficacy of a new blue light source in the treatment of mild to moderate inflammatory acne vulgaris in comparison to topical 1% clindamycin solution. RESULTS: Blue light therapy reduced inflammatory acne vulgaris lesions by an average of 34%, as compared to 14% for topical 1% clindamycin solution. CONCLUSIONS: The blue light source presented in this report is a safe and effective treatment option available to our patients with mild to moderate inflammatory acne lesions.

Acne Vulgaris↗