The effect of aging on the three-dimensional aspect of the hand: A pilot study.

BACKGROUND: With the increasing popularity of rejuvenation treatments of the skin, there has been an increase in patient inquiry for rejuvenation of the hand. Thus far, no imaging tool exists to analyze the aging process of the hand. Three-dimensional (3D) stereophotogrammetry is a reliable technique, which is used for other purposes in soft tissue analysis of the upper extremity. This pilot study aimed to investigate the possibility of visualizing the hand aging process by 3D stereophotogrammetry. METHODS: A total of 64 healthy volunteers were divided into four groups based on age and sex, and a 3D photograph of both hands was captured. Differences in the aspect of the dorsum of the hands were quantified and visualized using two methods. The first method quantified the smoothness of the old and young dorsa. The second method visualized the differences between an average young and old hand by creating a color-coded distance map. RESULTS: The first method showed that the young hands were smoother than the old hands; however, this difference was not statistically significant (p = 0.30). The distance map resulting from the second method showed a relative volume loss in the intermetacarpal spaces of the average old hand. These differences were not present when male hands were compared with female hands. CONCLUSIONS: This pilot study shows that 3D stereophotogrammetry can be used to visualize the exact areas of volume loss on the dorsum of the aging hand. On the basis of this finding, specific treatment areas can be identified, and the results of different esthetic hand surgery procedures can be objectively analyzed and compared.

Delivery of healthy babies after natalizumab use for multiple sclerosis: a report of two cases.

BACKGROUND: In current literature, no data on safety in pregnancy for new drugs in the treatment of multiple sclerosis (MS) like natalizumab (Tysabri®), a humanized monoclonal antibody against α4 integrins, are yet available. In the management of MS, natalizumab is the first monoclonal antibody approved to the market. METHODS: We describe the pregnancy and outcome in two women with MS using natalizumab. The first patient used it in the periconceptional period, and the second patient used it in both the periconceptional period and throughout gestation. RESULTS: The antenatal course of the first patient was complicated by an exacerbation of MS. The second patient did not experience MS relapses during pregnancy, while still using natalizumab. The newborns did not show any abnormalities postnatal and at 6 weeks' follow-up. CONCLUSIONS: This is the first detailed report on pregnancy and delivery of two babies after maternal treatment of MS with natalizumab. From the small number of cases on the usage of natalizumab during pregnancy in literature, we cannot conclude whether the use of natalizumab is safe, and long-term effects are not known. Further research is needed to establish the exact effects on pregnancy and intrauterine development as well as the long-term effects. Prenatal counseling with thorough explanation of the risks and careful decision making is advisable.