Symptoms of sleep disordered breathing and risk of cancer: a prospective cohort study.

STUDY OBJECTIVES: Sleep disordered breathing (SDB) has been associated with oxidative stress, inflammation, and altered hormonal levels, all of which could affect the risk of cancer. The aim of the study is to examine if symptoms of SDB including snoring, breathing cessations, and daytime sleepiness affect the incidence of total cancer and subtypes of cancer. DESIGN: Prospective cohort study. SETTING: The third wave (1991-1993) of the Copenhagen City Heart Study. PARTICIPANTS: There were 8,783 men and women in whom cancer had not been previously diagnosed. MEASUREMENTS AND RESULTS: Participants answered questions about snoring and breathing cessations in 1991-1993, whereas information about daytime sleepiness based on the Epworth Sleepiness Scale was collected in a subset of the participants (n = 5,894) in 1998. First-time incidence of cancer was followed until December 2009 in a nationwide cancer register. We found no overall association between symptoms of SDB and incident cancer. Yet, in the small group with high daytime sleepiness, we observed a surprisingly higher cancer incidence (hazard ratio = 4.09; 95% CI 1.58-10.55) in persons younger than 50 years. We also found a higher risk of virus/immune-related cancers (2.73; 1.27-5.91) and alcohol-related cancers (4.92; 1.45-16.76) among persons with daytime sleepiness. More SDB symptoms were associated with a higher risk of smoking-related cancers (Ptrend: 0.04). Apart from these findings there were no clear associations between symptoms of sleep disordered breathing and cancer subtypes. CONCLUSION: We found very limited evidence of relationship between symptoms of sleep disordered breathing and incidence of cancer.

Fractional nonablative 1,540-nm laser resurfacing of atrophic acne scars. A randomized controlled trial with blinded response evaluation.

The efficacy of nonablative fractional laser resurfacing of acne scars has been described in case reports and uncontrolled trials. The present study is the first randomized controlled trial in this field. The aim of this study was to examine the efficacy and adverse effects of 1,540-nm nonablative fractional laser treatment of acne scars. Ten patients with acne scars were included. Two intraindividual areas of similar size and appearance within contralateral anatomical regions were randomized to (1) 3-monthly laser treatments with a StarLux 1,540-nm fractional handpiece, and (2) no treatment. Blinded on-site clinical evaluations were performed before treatment, and at 4 and 12 weeks after the final treatment. End-points were overall change in scar texture (from score 0, even texture, to 10, worst possible scarring), adverse effects, change in skin colour (from score 0, absent, to 10, worst possible), and patient satisfaction (from score 0, no satisfaction, to 10, best imaginable satisfaction). Before treatment, scars were moderately atrophic and uneven in texture on both treated and untreated sides (median score 6.5, interquartile range 4.5-8; P=1). After treatment, laser-treated scars appeared more even and smooth than untreated control areas (4.5, 2-6.5, versus 6.5, 4.5-8, P=0.0156, at 4 weeks; 4.5, 2.5-6.5, versus 6.5, 4.5-8, at 12 weeks; P=0.0313). Patients were satisfied with the treatment (5.5, 1-7, after 12 weeks) and five of the ten patients evaluated their acne scars as moderately or significantly improved. No differences were found in skin redness or pigmentation between before and after treatment. Patients experienced moderate pain, erythema, oedema, bullae, and crusts. No adverse effects were seen in untreated control areas. The nonablative 1,540-nm fractional laser improves acne scars with a minimum of adverse effects.

Fractional nonablative 1540 nm laser resurfacing for thermal burn scars: a randomized controlled trial.

BACKGROUND AND OBJECTIVE: Burn scars cause permanent and disfiguring problems for many patients and limited treatments are available. Nonablative fractional lasers induce a wound healing response, which may lead to remodeling of burn scar texture. This randomized trial evaluates efficacy and adverse effects of 1540 nm fractional laser versus untreated control for burn scars. MATERIALS AND METHODS: Seventeen adult patients with burn scars of 1 year or older and Fitzpatrick skin types I-III were included in the study. Side-by-side test areas were randomized to (i) three monthly 1540 nm fractional laser treatments and (ii) no treatment. Blinded on-site response evaluations were performed 4 and 12 weeks after final treatment. Primary endpoints were change in skin texture (0-10 categorical scale), pain and adverse effects. Secondary endpoints were change in skin color and patient satisfaction (0-10 categorical scales). RESULTS: Preoperative skin texture was similar and moderately uneven in treated and untreated sites (6 (5.5-8), P = 1). Postoperative laser-treated skin appeared significantly more even and smooth compared to adjacent untreated control sides (4 weeks: 4 (2.5-6), P = 0.0015; 12 weeks: 4 (2-5), P = 0.0007). Patients were satisfied with treatments (week 12: 7 (4-8.5)) and 8/17 patients evaluated burn scars to be moderately or significantly improved. Skin redness increased transiently from laser treatments. No significant differences were found in skin pigmentation. Patients experienced moderate pain (5 (3.5-6)), erythema (17/17/16 patients, after first/second/third treatments), edema (9/9/8), bullae (3/0/3), and crusts (4/0/4). One patient had minor scarring. No adverse effects were seen in untreated control areas. CONCLUSIONS: Nonablative 1540 nm fractional laser improves burn scar texture, which raises a new potential for future burn scar treatment.

[Severe hypernatraemic dehydration in collodion baby]. / Svaer hypernatriaemisk dehydrering hos collodion baby.

Case report on severe hypernatraemic dehydration in a non-recognised collodion baby who also suffered from hydrops fetalis caused by supraventricular tachycardia. Excessive transcutaneous fluid loss caused s-Na+ reaching 182 mmol/l within 36 hours of birth. The infant was cautiously rehydrated during the following three days. No sign of neurologic impairment was observed. It is emphasized that early observation of the collodion baby must take place in a humidified incubator. Major weight changes in the newborn should always result in analysis of serum sodium.