Microneedling versus microcoring: A review of percutaneous collagen induction for the face and neck.

BACKGROUND: Microneedling (MN) and microcoring (MCT) are both methods used for percutaneous collagen induction. This minimally invasive technique involves creating controlled damage in cutaneous tissue to induce neocollagenesis and neoelastogenesis. MN utilizes solid microneedles and is commonly combined with radiofrequency (RF) to add thermal energy, while MCT involves hollow microneedles capable of removing excess tissue without inducing scar formation. AIMS: The purpose of this review was to summarize recent literature for MN and MCT, with the goal of assisting clinical decision making regarding the use of these technologies. METHODS: PubMed search was conducted for relevant articles published within the last 10 years. Scoping literature review was then performed with pertinent findings reported. RESULTS: Existing literature investigating MCT is sparse. Limited data on in vivo, human effects of this technology exist. Two out of 14 studies in this review pertained to MCT. CONCLUSION: Additional high-powered clinical studies are needed to guide future cosmetic treatments with MN and MCT.

A profile approach to impulsivity in bipolar disorder: the key role of strong emotions.

OBJECTIVE: Bipolar disorder has been associated with elevated impulsivity - a complex construct subsuming multiple facets. We aimed to compare specific facets of impulsivity in bipolar disorder, including those related to key psychological correlates of the illness: reward sensitivity and strong emotion. METHOD: Ninety-one individuals diagnosed with bipolar I disorder (inter-episode period) and 80 controls completed several well-validated impulsivity measures, including those relevant to reward (Fun-seeking subscale of the Behavioral Activation System scale) and emotion (Positive Urgency and Negative Urgency scales). RESULTS: Bipolar participants reported higher impulsivity scores than did controls on all of the impulsivity measures, except the Fun-seeking subscale of the Behavioral Activation System scale. Positive Urgency - a measure assessing the tendency to act impulsively when experiencing strong positive emotion - yielded the largest group differences: F(1,170) = 78.69, P < 0.001, partial η(2)  = 0.316. Positive Urgency was also associated with poorer psychosocial functioning in the bipolar group: ΔR(2)  = 0.24, b = -0.45, P < 0.001. CONCLUSION: Individuals with bipolar I disorder appear to be at particular risk of behaving impulsively when experiencing strong positive emotions. Findings provide an important first step toward developing a more refined understanding of impulsivity in bipolar disorder with the potential to inform targeted interventions.

Analysis of the coding regions of VEGFR3 and VEGFC in Milroy disease and other primary lymphoedemas.

Milroy disease (hereditary lymphoedema type I, MIM 153100) is a congenital onset primary lymphoedema with autosomal dominant inheritance. Mutations in the gene, vascular endothelial growth factor receptor 3, VEGFR3 (FLT4), are known to cause Milroy disease, but there is uncertainty about the prevalence of VEGFR3 mutations in patients with primary lymphoedema and more specifically in those with a phenotype that resembles Milroy disease. This study aims to address this issue and thereby delineate the Milroy disease phenotype. Fifty-two patients with primary lymphoedema were analysed for mutations in the coding regions of VEGFR3. Patients were divided into four groups: Typical Milroy disease with family history (group I), typical Milroy disease with no family history (group II), atypical Milroy disease (group III), and complex primary lymphoedema (group IV). Results demonstrated that with rigorous phenotyping the likelihood of detecting VEGFR3 mutations is optimised. Mutation prevalence is 75% in typical Milroy patients with a family history (group I) and 68% if positive family history is not a diagnostic criterion. A positive family history is not essential in Milroy disease. The likelihood of detecting VEGFR3 mutations in patients who have a phenotype which is not typical of Milroy disease is very small (<5%). For the 22 mutation positive patients, 14 novel VEGFR3 mutations were identified, two of which were in exon 22 and one in exon 17, confirming that these exons should be included in VEGFR3 analysis. No mutations were found outside the kinase domains, showing that analysis of this part of the gene is not useful for Milroy disease patients. VEGFC, which encodes the ligand for VEGFR3, was sequenced in all patients with typical Milroy disease (groups I and II) and no mutations were identified.

Psychological general well-being (quality of life) in patients with cochlear implants: importance of social environment and age.

The purpose of this study was to investigate the variables that affect psychological general well-being (quality of life) in patients with cochlear implants (CIs). The study sample consists of 96 adult patients with a CI, aged 24 86 years (Mean = 61.8 yrs; SD = 15.3 yrs). 48 were patients from the Sahlgrenska University Hospital in Sweden and 48 were patients from the University of Florida, USA. The Psychological General Well-being Index and the International Outcome Inventory-Cochlear implants were used in collecting data. Possible independent variables were socioeconomic factors such as age, gender, nationality, living arrangement, education, and social support; as well as length of time since implantation, age when hearing loss became a problem, and subjective benefit of the CI. A stepwise multiple regression analysis showed that 49% of the variance was explained by attitudes from others, restricted social participation, perceived social support and age.

Evaluation of the BAX system for detection of Listeria monocytogenes in foods: collaborative study.

A multilaboratory study was conducted to compare the automated BAX system and the standard cultural methods for detection of Listeria monocytogenes in foods. Six food types (frankfurters, soft cheese, smoked salmon, raw, ground beef, fresh radishes, and frozen peas) were analyzed by each method. For each food type, 3 inoculation levels were tested: high (average of 2 CFU/g), low (average of 0.2 CFU/g) and uninoculated controls. A total of 25 laboratories representing government and industry participated. Of the 2335 samples analyzed, 1109 were positive by the BAX system and 1115 were positive by the standard method. A Chi square analysis of each of the 6 food types, at the 3 inoculation levels tested, was performed. For all foods, except radishes, the BAX system performed as well as or better than the standard reference methods based on the Chi square results.

Factors predicting the use of complementary therapies in a multi-ethnic sample of early-stage breast cancer patients.

OBJECTIVES: to examine predictors of use of complementary therapies reported by women who had also received standard medical treatment for early-stage breast cancer. METHODS: A volunteer sample of 231 black, Hispanic, and non-Hispanic white patients with early-stage breast cancer (diagnosed within the preceding year) reported their use of complementary therapies. We examined predictors of the use of each therapy from among a set of demographic and quality of life measures. RESULTS: Most women reported using 1 complementary therapy or more, most commonly psychotherapy, support groups, meditation, and spiritual healing. Use of psychotherapy related to age, education, and elevated distress. Use of other complementary therapies was not related to distress. More black than Hispanic or non-Hispanic white patients used herbal therapies and spiritual healing. Use of complementary therapies did not relate to expectation of recurrence, dissatisfaction with medical care, or (among relevant patients) concerns about the consequences of chemotherapy. CONCLUSIONS: Use of healing therapies that do not replace medical treatment should be viewed as attempts to increase potential benefit and not as signs of distress or dissatisfaction. Use of complementary therapies also varies across racial and ethnic groups.

Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer.

The authors tested effects of a 10-week group cognitive-behavioral stress management intervention among 100 women newly treated for Stage 0-II breast cancer. The intervention reduced prevalence of moderate depression (which remained relatively stable in the control condition) but did not affect other measures of emotional distress. The intervention also increased participants' reports that having breast cancer had made positive contributions to their lives, and it increased generalized optimism. Both remained significantly elevated at a 3-month follow-up of the intervention. Further analysis revealed that the intervention had its greatest impact on these 2 variables among women who were lowest in optimism at baseline. Discussion centers on the importance of examining positive responses to traumatic events--growth, appreciation of life, shift in priorities, and positive affect-as well as negative responses.

An exploratory study of social support, distress, and life disruption among low-income Hispanic women under treatment for early stage breast cancer.

Relationships between distress and perceived availability of social support were examined in 51 Hispanic women being treated for early stage breast cancer. Distress and different types (emotional, instrumental) and sources (spouse, women family members, other family members, friends) of support were measured at presurgery, postsurgery, and at 3-, 6-, and 12-month follow-ups. Emotional support from friends and instrumental support from spouse at presurgery predicted lower distress postsurgery. No other prospective benefits of perceived support emerged. Distress at several time points predicted erosion of subsequent support, particularly instrumental support from women in the family. In contrast to the adverse effects of distress (and independent of them), illness-related disruption of recreational and social activities at 6 months elicited greater support at 12 months.

Negative childhood accounts, sensitivity, and pessimism: a study of avoidant personality disorder features in college students.

Theory suggests that individuals with avoidant personality disorder (APD) may have experienced rejection or isolation during childhood, that they may be temperamentally hypersensitive, and that they may hold pessimistic expectancies. In a sample of 127 undergraduates, negative childhood memories, sensory-processing sensitivity, and pessimism were assessed. To measure childhood memories, participants wrote open-ended narratives that were evaluated for valence by independent raters. To measure APD features, participants rated the degree of which verbatim DSM-IV criteria were descriptive of themselves. Negative childhood accounts, self-reports of sensory-processing sensitivity, and pessimism were correlated with DSM-IV APD features, even after controlling for the influence of present negative mood. Interactions suggested that pessimism was more strongly related to APD features among participants who were either highly sensitive or recalled adverse childhood experiences (e.g., isolation, rejection, conflict). Implications for theory and intervention are discussed.

On the continuous calibration of happiness.

The nature of happiness is considered. A model is reviewed in which the affect system is continuously recalibrated regarding a given domain of experiences as a function of the dominant affective tone those experiences have over time. In this view, people who experience repeated negative affect in a domain undergo an adjustment such that they become less demanding about the quality of experience producing happiness; people who experience repeated positive affect in a domain undergo an adjustment such that they become more demanding about the quality of experience required for happiness. Each results in a re-balancing of the system. As objective circumstances vary, the person still experiences both happiness and unhappiness. Implications are considered for large life changes and for individuals with disabilities.

Cognitive-behavioral stress management reduces serum cortisol by enhancing benefit finding among women being treated for early stage breast cancer.

OBJECTIVE: This study examined the effects of a cognitive-behavioral stress management (CBSM) group intervention on serum cortisol levels in women being treated for stage I or II breast cancer. METHODS: Participants were randomly assigned to undergo a 10-week intervention (N = 24) within 8 weeks after surgery or were placed on a waiting list (N = 10). Cortisol was assessed by means of a radioimmunoassay of blood samples collected at the same time of day just before the start of the intervention and immediately after its completion. The women also reported the degree to which breast cancer had made positive contributions to their lives. RESULTS: Intervention participants showed increased benefit finding and reduced serum cortisol levels, whereas control subjects experienced neither change. Path analysis suggested that the effect of CBSM on cortisol was mediated by increases in benefit finding. CONCLUSIONS: These findings suggest that positive growth enhanced during a time-limited intervention can influence physiological parameters such as cortisol among women with early stage breast cancer.

Scaling back goals and recalibration of the affect system are processes in normal adaptive self-regulation: understanding 'response shift' phenomena.

This comment addresses a set of phenomena that have been labeled 'response shift'. We argue that many of these phenomena reflect recalibration of a goal-seeking system and an affect-management system, both of which are involved in normal adaptive self-regulation. In brief, we hold that these systems act as feedback control mechanisms. The reference values for both systems continuously undergo gradual recalibration. Because in most circumstances the adjustments tend to occur with equivalent frequency in both directions, their cumulative effect is minimal. In situations of either unusually prolonged goal attainment (and overattainment) or unusually prolonged adversity (as occurs, e.g., with deteriorating health), the cumulative effect can be substantial. We believe that these latter recalibrations of reference value account for many response shift phenomena. Other such phenomena are accounted for by the principle of hierarchical organization among the self-regulatory goals that comprise the self.

Coping, mood, and aspects of personality in Spanish translation and evidence of convergence with English versions.

Research on stress and its influence on health and well-being has flourished for several decades, examining as predictors such psychosocial variables as personality and coping. This work now often targets multiethnic samples. Because many potential participants lack facility in English, a need exists for translations of measures into other languages. We translated 6 instruments into Spanish and studied their characteristics. Of these, 3 were measures of personality qualities: the Life Orientation Test--Revised (Scheier, Carver, & Bridges, 1994), the Behavioral Inhibition/Behavioral Activation Scales (Carver & White, 1994), and the Measure of Body Apperception (Carver et al., 1998). The others were the Brief COPE (Carver, 1997), the Center for Epidemiological Studies--Depression Scale (Radloff, 1977), and an abbreviated version of the Profile of Mood States (McNair, Lorr, & Droppelman, 1971). Correlations between English and Spanish versions in bilingual samples were all above. 72, except for the COPE's Behavioral Disengagement scale. Alpha reliabilities of the Spanish versions were comparable to those of the English versions. Correlations among measures in a sample of cancer patients were similar across languages.

Responsiveness to threats and incentives, expectancy of recurrence, and distress and disengagement: moderator effects in women with early stage breast cancer.

Models of neurobiological systems linking personality, motivation, and emotion can be integrated with the expectancy construct to suggest hypotheses about distress and giving up in response to adversity. In 220 women with breast cancer, threat responsiveness-sensitivity of the behavioral inhibition system (BIS)-and incentive responsiveness-sensitivity of the behavioral activation system (BAS)-and expectancies about cancer recurrence were measured. It was predicted and found that high BIS sensitivity interacted with recurrence expectancy to predict elevated distress and disengagement. Low BAS sensitivity (reward responsiveness) also interacted with expectancy of recurrence to predict elevated disengagement. In contrast, high BAS sensitivity (fun seeking) interacted with recurrence expectancy to predict elevated distress. Discussion centers on theoretical implications and possible applications.

Influences of personality and coping variables on health behaviors and health outcomes.

Many health problems begin with behavior: taking risks or failing to take proper precautions. Psychosocial processes of several types underlie such behaviors. It follows that research on health can benefit from considering psychosocial processes as well as biological ones. This article focuses on two general domains of psychological influences on health--personality and coping. Several approaches to the domain of personality are described, along with several issues involved in the conceptualization of coping. Examples of research on how these phenomena relate to health behaviors and health outcomes are presented.

Optimism and rehospitalization after coronary artery bypass graft surgery.

OBJECTIVE: To determine whether optimism predicts lower rates of rehospitalization after coronary artery bypass graft surgery for the 6 months after surgery. METHODS: A prospective, inception cohort design was used. The sample consisted of all consenting patients (N=309) from a consecutive series of patients scheduled for elective coronary artery bypass graft surgery at a large, metropolitan hospital in Pittsburgh, Pa. To be eligible, patients could not be scheduled for any other coincidental surgery (eg, valve replacement) and could not be in the cardiac intensive care unit or experiencing angina at the time of the referral. Participants were predominantly men (69.9%) and married (80.3%), and averaged 62.8 years of age. Recruitment occurred between January 1992 and January 1994. RESULTS: Compared with pessimistic persons, optimistic persons were significantly less likely to be rehospitalized for a broad range of aggregated problems (including postsurgical sternal wound infection, angina, myocardial infarction, and the need for another bypass surgery or percutaneous transluminal coronary angioplasty) generally indicative of a poor response to the initial surgery (odds ratio=0.50, 95% confidence interval=0.33- 0.76; P=.001). The effect of optimism was independent of traditional sociodemographic and medical control variables, as well as independent of the effects of self-esteem, depression, and neuroticism. All-cause rehospitalization also tended to be less frequent for optimistic than for pessimistic persons (odds ratio=0.77, 95% confidence interval=0.57-1.05; P=.07). CONCLUSIONS: Optimism predicts a lower rate of rehospitalization after coronary artery bypass graft surgery. Fostering positive expectations may promote better recovery.

Concerns about breast cancer and relations to psychosocial well-being in a multiethnic sample of early-stage patients.

Much work on psychosocial sequelae of breast cancer has been guided by the assumption that body image and partner reaction issues are focal. In a tri-ethnic sample of 223 women treated for early-stage breast cancer within the prior year, the authors assessed a wider range of concerns and relations to well-being. Strongest concerns were recurrence, pain, death, harm from adjuvant treatment, and bills. Body-image concerns were moderate; concern about rejection was minimal. Younger women had stronger sexual and partner-related concerns than older women. Hispanic women had many stronger concerns and more disruption than other women. Life and pain concerns and sexuality concerns contributed uniquely to predicting emotional and psychosexual disruption; life and pain concerns and rejection concerns contributed to predicting social disruption. In sum, adaptation to breast cancer is a process bearing on several aspects of the patient's life space.

Religiosity, Religious Coping, and Distress: A Prospective Study of Catholic and Evangelical Hispanic Women in Treatment for Early-stage Breast Cancer.

Religious involvement was measured in a sample of 49 lower socio-economic status Hispanic women who were newly diagnosed with early-stage breast cancer. Religious coping and emotional distress were assessed at pre-surgery, post-surgery, and at 3-, 6-, and 12-month follow-ups. Among Catholic women, greater religiosity tended to be associated with more distress throughout the year; among Evangelical women, in contrast, greater religiosity tended to be associated with less distress throughout the year. These correlations were significantly different at two measurement points. Similarly, religious coping tended to have divergent effects in the two groups. Among Catholics, church attendance at 6 months predicted greater distress at 12 months; among Evangelical women, obtaining emotional support from church members at 6 months predicted less distress at 12 months. These various differences are interpreted in terms of differences in the ideologies of the two religious groups.