A comparative clinical study of different hair removal procedures and their impact on axillary odor reduction in men.

BACKGROUND: Axillary hair can influence the development of underarm odor in men. OBJECTIVE: To compare different hair removal procedures and their impact on the effectiveness of standard soap washing (SW) in reducing male axillary odor. METHODS: The axillae of healthy Caucasian males (N = 30; 18-48 years of age) were randomized in a non-crossover, split body design. Two of four axillary treatments were evaluated per subject: clipped with scissors; wet shaved with a razor; waxed; and untreated. Odor evaluations were performed by trained assessors according to the American Society for Testing and Materials organization at baseline (24 h postcontrol SW), immediately, 12 and 24 h following treatment plus SW (Day 1). Further evaluations were conducted immediately and 24 h following SW on Day 2 and Day 3. Mean odor scores were calculated and an analysis of covariance conducted using baseline data as covariate. RESULTS: On Day 1, hair removal by clipping with scissors followed by SW offered no significant improvement in immediate odor control (27.2% reduction from baseline) when compared with SW alone. Both shaving and waxing followed by SW resulted in an immediate, significant reduction in axillary odor compared with SW alone (57.3% and 75.3% reduction, respectively; P < 0.0001). This improvement persisted for 24 h after shaving (P = 0.0682). Further, a single shaving treatment significantly improved the immediate effectiveness of SW on Day 1, Day 2, and Day 3 compared with SW alone (P < 0.05). CONCLUSIONS: Blade shaving of the axillae can optimize the cleansing and odor reducing effectiveness of daily hygiene measures for men without the discomfort associated with waxing.

Evaluation of image quality and patient safety: paired inspiratory and expiratory MDCT assessment of tracheobronchomalacia in paediatric patients under general anaesthesia with breath-hold technique.

OBJECTIVE: The purpose of our investigation was to evaluate image quality and patient safety in infants and young children who required general anaesthesia with breath-hold technique for paired inspiratory and expiratory multidetector CT (MDCT) assessment of tracheobronchomalacia (TBM). MATERIALS AND METHODS: Our hospital's institutional review board approved the review of radiological and clinical data of a consecutive series of 20 paediatric patients who underwent MDCT under general anaesthesia with breath-hold technique for evaluation of TBM from May 2006 to December 2008. For each MDCT study, two fellowship-trained paediatric radiologists reviewed the inspiratory and expiratory MDCT images in an independent, randomised and blinded fashion for the presence of motion artefact at three anatomic levels (upper, middle and lower central airways). The clinical history and anaesthesia outcome, including the occurrence of any adverse events during or following the MDCT examinations until discharge, were also reviewed and recorded. RESULTS: The study population consisted of 20 infants and young children (13 boys/seven girls, mean age 1.7 ± 1.4 years, age range 11 days to 4 years). The imaging quality of all 20 MDCT studies was diagnostic with no motion artefact in 16 studies (80%) and minimal motion artefact in the remaining four studies (20%). Minor adverse events occurred in three patients (15%) that included one patient (5%) with a brief (<60 s) oxygen desaturation during MDCT study, which resolved with oxygen, and two patients (5%) with either a brief (<60 s) oxygen desaturation (n = 1, 5%) or cough (n = 1, 5%) during recovery period, which were completely resolved with oxygen and dexamethasone, respectively. CONCLUSION: Diagnostic quality paired inspiratory and expiratory MDCT imaging with breath-hold technique can be safely performed in infants and young children under general anaesthesia for evaluation of TBM.

An exaggerated hypertensive response to glycopyrrolate therapy for bradycardia associated with high-dose dexmedetomidine.

At our institution, high-dose i.v. dexmedetomidine is used to provide sedation for pediatric patients undergoing nonpainful radiological imaging studies. Some of these patients exhibit marked bradycardia (more than 20% deviation from the lowest age-adjusted normal values) while maintaining an arterial blood pressure within an acceptable normal range. We report on three cases wherein treatment of dexmedetomidine-induced bradycardia with i.v. glycopyrrolate (5.0 microg/kg) not only resulting in resolution of bradycardia but also resulting in an exaggerated increase of arterial blood pressure.

Dexmedetomidine for pediatric sedation for computed tomography imaging studies.

Dexmedetomidine is a sedative with limited experience in the pediatric population. This is the first study that prospectively evaluates the sedation profile of a dexmedetomidine pilot program for pediatric sedation for radiological imaging studies. In March 2005, our hospital sedation committee approved the replacement of IV pentobarbital with dexmedetomidine as the standard of care for CT imaging. Detailed Quality Assurance (QA) data sheets collect relevant information on each patient, which is then logged into a computerized sedation database. After IRB approval, all QA data was accessed. Sixty-two patients with a mean age of 2.8 years (SD = 1.8, range 0.5-9.7) received IV (IV) dexmedetomidine administered as a 2 mcg/kg loading dose over 10 minutes, followed by repeat boluses of 2 mcg/kg over 10 minutes until target of Ramsay Sedation Score 4 (RSS) achieved. Patients were then maintained on 1 mcg/kg/hr infusion until imaging is completed. Repeated-measures ANOVA indicated that compared to pre-sedation values, the heart rate and mean arterial blood pressure decreased an average of 15% during bolus, infusion and recovery (P < 0.01). No significant changes were observed in respiratory rate or end-tidal CO2. Mean recovery time was 32 +/- 18 minutes. Based on our pilot results, dexmedetomidine may provide a reliable and effective method of providing sedation.