Anaphylaxis to IGIV in immunoglobulin-naïve common variable immunodeficiency patient in the absence of IgG anti-IgA antibodies: successful administration of low IgA-containing immunoglobulin.

Although severe reactions to immunoglobulin preparations have been frequently reported, IgE antibodies against IgA are usually not investigated; and occur predominantly in previously sensitized patients. The purpose is to report anaphylaxis to IGIV during initial infusion in a patient with common variable immunodeficiency with absent IgA without prior sensitization and in the absence of detectable IgG anti-IgA antibodies, and positive skin tests for immediate hypersensitivity to four different preparations of IGIV, one subcutaneous immunoglobulin preparation, and to purified IgA. Patient was treated without side effects with IGIV preparation depleted of IgA to which immediate hypersensitivity skin test was negative.

Good syndrome presenting with CD8⁺ T-Cell large granular lymphocyte leukemia.

Good Syndrome is an adult-onset combined immunodeficiency defined by hypogammaglobulinemia, low or absent number of B cells, T cell deficiency and thymic tumor. We have characterized CD8+ T cells from a patient with Good syndrome that presented with CD8+T-cell large granular lymphocytic leukemia (LGL). Characterization of peripheral blood CD8+ T cells revealed that majority of CD8+ T cells were terminally differentiated effector memory phenotype (TEMRA; CD8+CCR7-CD45RA+), and were PD-1high (CD279), ICOSlow (CD278), and granzymehigh.

Double-blind, Placebo-controlled Study Assessing the Effect of Chocolate Consumption in Subjects with a History of Acne Vulgaris.

Objective: To assess the effect of chocolate on acne exacerbation in males between the ages of 18 and 35 with a history of acne vulgaris.

Design: Double-blind, placebo-controlled, randomized, controlled trial.

Setting: Single-site, outpatient, research, clinical facility at an academic research institution.

Filler injections with the blunt-tip microcannula.

Background: Microcannulas with blunt tips for filler injections have recently been developed for use with dermal fillers. Their utility, ease of use, cosmetic outcomes, perceived pain, and satisfaction ratings amongst patients in terms of comfort and aesthetic outcomes when compared to sharp hypodermic needles has not previously been investigated.

Objective: To compare injections of filler with microcannulas versus hypodermic needles in terms of ease of use, amount of filler required to achieve desired aesthetic outcome, perceived pain by patient, adverse events such as bleeding and bruising and to demonstrate the advantages of single-port injection technique with the blunt-tip microcannula.

The optimal filler: immediate and long-term results with emulsified silicone (1,000 centistokes) with cross-linked hyaluronic acid.

Background: Silicone is one of the oldest and longest lasting of the dermal fillers. Microdroplet silicone injections have proven to be safe and effective. This paper describes how to obtain microdroplet silicone (1,000 centistokes) in a consistent manner, including a discussion of its efficacy and safety.

Virtually painless local anesthesia: diluted lidocaine proves to be superior to buffered lidocaine for subcutaneous infiltration.

Background: Many physicians believe that buffering local anesthetics with sodium bicarbonate is the best technique for reducing the pain and discomfort associated with subcutaneous infiltration.

Objective: To compare the level of pain and discomfort associated with subcutaneous infiltration of lidocaine diluted with normal saline to that associated with traditionally buffered lidocaine.

Patients/methods: In a prospective, double-blind trial, 31 patients were asked to use a visual analog scale to rank the level of pain and discomfort caused by two different solutions of lidocaine with epinephrine.

Safety, efficacy, and patient acceptability of imiquimod for topical treatment of actinic keratoses.

Imiquimod, an immune-modulating imidazoquinoline compound, has been approved in topical formulation for the treatment of actinic keratoses, superficial basal cell carcinomas, and external genital warts. Its use in the treatment of field cancerization, in particular, has been rapidly evolving. With the recent approval of a new drug application for a new concentration, as well as generic formulations, this drug has emerged at the forefront of treatment for actinic keratoses, with improved dosage scheduling and more patients having access to generic options.

Advances in the treatment of keloids.

Occurring with higher proportions in skin of color, keloid formation is seen in individuals of all races, with the lowest incidence in albinos. Interestingly, prevalence of keloids is correlated to skin pigmentation, with dark-skinned individuals suffering disproportionately. Many factors are taken into consideration when deciding which modalities to use in the treatment of keloids, including size, anatomical site, cause, symptoms, duration of treatment and not least importantly, pigmentation of the patient.

Comparison of short-pulsed and long-pulsed 532 nm lasers in the removal of freckles.

The purpose of this study was to compare the efficacy and safety of the 532 nm long-pulsed laser (10 ms) with that of the 532 nm short-pulsed laser (10 ns) for freckle removal. Currently, the gold standard for treatment is the short-pulsed laser. Recently, several long-pulsed lasers have been introduced for both hair removal and the treatment of freckles.

Comparison of the effects of short- and long-pulse durations when using a 585-nm pulsed dye laser in the treatment of new surgical scars.

More than 70 million surgical procedures are performed annually in the USA with the majority involving a skin lesion and almost all individuals in their lifetime will have one or more surgical procedures resulting in scars. Patients and physicians alike are thereby motivated to improve the cosmetic outcome of scars. Prior studies have shown that the pulsed dye laser (PDL) is effective in improving the quality and appearance of the scar when using the 585-nm PDL immediately after the removal of sutures.

Lentiviral vector-mediated transduction of neural progenitor cells before implantation into injured spinal cord and brain to detect their migration, deliver neurotrophic factors and repair tissue.

Purpose: Stem cells represent an attractive source for cell replacement therapy in neurological disorders due to their self-renewal and multi-potency. Genetic manipulation of these cells may allow controlled release of therapeutic proteins, suppress immune rejection, or produce essential neurotransmitters. Furthermore, when the expression cassette is incorporated into the host genome ex vivo, this technique also may be used as a method to trace cells following implantation into tissues of interest.

Effect of behavioral interventions on insulin sensitivity and atherosclerosis in the Watanabe heritable hyperlipidemic rabbit.

Objective: A previous study suggested that insulin metabolic variables play a role in the progression of atherosclerosis in Watanabe heritable hyperlipidemic (WHHL) rabbits. The present study sought to determine: 1) if young, individually caged WHHLs are insulin-resistant relative to New Zealand white (NZW) rabbits and 2) whether dietary or exercise interventions can improve insulin sensitivity and slow the development of atherosclerosis in these animals.

Methods: Forty-two WHHLs were assigned to a dietary, exercise, or control condition, and 12 NZWs were used as a comparison control group.