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New technologies safe and effective for fat removal – News

For many people, getting rid of excess fat can be a lifelong battle. Whether it is undesirable love handles, excess fat around the knees or flabby upper arms, pockets of fat can be difficult to reduce and sometimes diet and exercise are not enough to make a noticeable difference. Now, dermatologists are finding that the introduction of non-invasive fat removal technologies is opening the door for more people who are not candidates for liposuction to remove stubborn fat, safely and effectively.

"Fat cells are by nature very different than other cells, particularly in how they respond to stimuli such as temperature," said dermatologist Lisa M. Donofrio, MD, FAAD, associate clinical professor, department of dermatology, Yale University School of Medicine, New Haven, Conn. "Most of the new technologies recently introduced for fat removal were developed based on this knowledge and, as a result, can target specific areas of body fat using energy delivered as either heat or cold."

Radiofrequency: A Hot New Way to Target Fat
One of the newest fat reduction technologies is radiofrequency, which delivers energy to the areas of fat by driving controlled heat deep within the fat cells and subsequently destroys them. While radiofrequency has not yet been approved by the U.S. Food and Drug Administration (FDA) for fat removal, Dr. Donofrio explained that the technology is being widely used by dermatologists with much success for people with pockets of excess fat. Since there is no downtime with this procedure, patients can resume their regular activities immediately.

"Radiofrequency is a very versatile procedure that can be used on any area of the body - from large areas like the abdomen to very small areas such as the chin - with the same degree of success," said Dr. Donofrio. "For people who are not considered overweight but have stubborn pockets of unwanted fat that are not responding to diet and exercise, radiofrequency is a good option."

Another benefit of radiofrequency is its ability to both reduce fat and tighten the skin by directing energy to target collagen. For example, a patient with flabby upper arms may have more loose skin than fat in this area. In this instance, Dr. Donofrio might use radiofrequency to tighten the skin first and then remove excess fat. However, if she determines that there is mostly fat in an area, she would remove the fat first and then tighten the skin afterward.

Cryolipolysis: Putting the Freeze on Fat
A new, non-invasive procedure approved by the FDA that is being used to remove localized areas of fat in the lower abdomen or along the sides of the body is cryolipolysis. Since fat cells are more sensitive to cold temperatures than other skin cells, cryolipolysis freezes the lipids in fat cells which then slowly dissolve with no trauma or injury to surrounding tissues. For this reason, results are not immediate and fat layer reduction becomes visible gradually over the course of two to six months.

"While cryolipolysis is a very innovative approach for fat reduction, the machine itself is limiting and not as versatile as radiofrequency - as it currently only allows for the treatment of larger areas of fat," explained Dr. Donofrio. "However, future developments in cryolipolysis could enable dermatologists to treat the inner thighs, neck and arms for more refined fat reduction."

Article source: http://www.news-medical.net/news/20120208/New-technologies-safe-and-effective-for-fat-removal.aspx

Photodynamic Therapy Now Available at Metropolitan Dermatology

Clark, NJ, February 08, 2012 --(PR.com)-- Dr. Alexander Doctoroff and the staff of Metropolitan Dermatology are happy to announce the availability of a novel treatment for nail fungus (onychomycosis): photodynamic therapy (PDT). PDT is a combination of topical medication and light therapy.

Photodynamic therapy with the medication Levulan® is a relatively new and exciting development in dermatology. It is used for various skin conditions ranging from acne to pre-cancerous and cancerous growths. It is also used to rejuvenate facial skin. Photodynamic therapy has been extensively used at Metropolitan Dermatology since March 2010. And now with the latest research on PDT use for toe nail fungus now available, Metropolitan Dermatology is making this significant advance available to our patients. To the office's knowledge, Metropolitan Dermatology is the first dermatology practice in New Jersey to offer PDT for the treatment of nail fungus.

Currently, the most commonly used treatments for toe nail fungus are oral medications and various topical antifungals. While effective, the oral pills may have significant side effects on the liver. Topical antifungals lack efficacy and have to be used for a long time (6 months to a year) to achieve improvement. When they are discontinued, the condition often returns. In contrast, photodynamic therapy provides effective therapy for fungus without the potential liver side effects of oral medications.

The procedure starts with the application of a urea gel to the toenails for 10 days. This thins the nails and makes them more amenable for treatment. Thereafter, Levulan® Kerastick® (20% solution of Aminolevulinic Acid), a clear and painless liquid, is applied to the nails. After several hours, the area is exposed to the light with a wavelength of 411nm. The light activates Levulan® to destroy the fungus. Several treatments are usually needed for optimal results.

In addition, PDT is FDA-approved for the treatment of actinic keratoses (pre-cancerous growths). It is very effective and usually produces no scarring. That contrasts with the traditional liquid nitrogen treatment known to result in white discoloration.

PDT is also effective for acne treatment. The advantage of PDT for acne is the chance to avoid oral antibiotics, oral contraceptives, and isotretinoin.

Sun damage, fine lines, and blotchy pigmentation are also improved with PDT because of the positive effect of Levulan® and the light treatment. The advantage of PDT for cosmetic treatments is that it is one of the least expensive rejuvenation options available.

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Article source: http://www.pr.com/press-release/388908

Mastering Advances in Dermatology – Beyond Skin Deep

GREENSBORO, N.C., Feb. 8, 2012 /PRNewswire/ -- Mastering Advances in Dermatology: Beyond Skin Deep, a new conference, designed to bring together dermatologists with specific areas of expertise, will convene in Greensboro, NC on March 31-April 1, 2012 for a day and a half summit.   The goal of the conference is to provide increased knowledge for the practicing dermatologist, dermatology PAs and nurses as well as residents and fellows, by presenting the latest information in key areas of medical dermatology such as malignancies, acne, infectious disease, psoriasis, pediatric dermatology and OTC agents.  An aesthetic workshop that will review facial injectable products with live patient demonstrations will also be offered. 

According to Program Chairman Joseph L. Jorizzo, Professor, Former Founding Chair, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC and Adjunct Professor, Department of Dermatology, Weill Cornell Medical College, New York, NY, "While there are many excellent dermatology meetings available, the focus of this conference will be on specific clinical challenges that we all face and to hear from experts; in a very succinct manner; their approach and treatment algorithms for dealing with these challenges. Both practicing dermatologists, those who assist in their practice and residents/fellows will benefit from the information presented." 

The agenda has been carefully developed to provide attendees with an opportunity to hear pearls of knowledge, based on the clinical experiences of the faculty.   Lectures are organized by category, are no more than 15 minutes in length and each session finishes with a rigorous panel discussion with time for QA.  Up to 8.5 hours of CME credits will be available for attendees.

The prestigious faculty includes, Victoria Barrio, MD, Brian Berman, MD, PhD, Neal Bhatia, MD,  Robert E. Clark, MD, PhD, Sue Ellen Cox, MD, James Q. Del Rosso, DO, Luis Diaz, MD, Zoe Draelos, MD, Steven Feldman, MD, Alan Fleisher, Jr, MD, Timothy Flynn, MD, Gloria F. Graham, MD, Mark Lebwohl, MD, Elise Olsen, MD, David M. Pariser, MD, Theodore Rosen, MD, Lawrence Schachner, MD and Bruce Theirs, MD

About Mastering Advances in Dermatology: Beyond Skin Deep:  The 1st Annual Conference is designed to bring faculty with years of clinical and research experience together to discuss challenges and solutions in medical and aesthetic dermatology.

For more information about registration for the 1st Annual Mastering Advances in Dermatology: Beyond Skin Deep conference, please visit https://xmedicacme.com/beyondskindeep or contact info@xMedicaCME.com

Like us on http://www.facebook.com/pages/Mastering-Advances-In-Dermatology-Beyond-Skin-Deep/348220258533640#!/pages/Mastering-Advances-In-Dermatology-Beyond-Skin-Deep/348220258533640?sk=wall and follow us on Twitter twitter.com/#!/mastersinderm for daily updates and news

 

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Article source: http://www.prnewswire.com/news-releases/mastering-advances-in-dermatology---beyond-skin-deep-138919084.html

Doctors cheating in dermatology exams

Health
Friday, February 3rd, 2012

Doctors studying to become dermatologists have, for years, shared exam questions by memorizing and writing them down after the test to become board certified, CNN has confirmed.

Reports of the use of what are known as “airplane notes” comes after revelations last month that radiology residents around the country for years also have used what are known as “recalls” to prepare for the written exam, which is one step in becoming certified by the American Board of Radiology.

In the wake of the CNN story, the group that oversees 24 medical specialties issued a statement condemning the use of the recalls.

The American Board of Medical Specialties said on its website that, “It should be made abundantly clear that recalling and sharing questions from exams violates exam security, professional ethics and patient trust in the medical profession. When it happens, the practice should be addressed swiftly and decisively. Whether someone is providing or using test questions, ABMS Member Boards enforce sanctions that may include permanent barring from certification, and/or prosecution for copyright violation.”

CNN has confirmed the practice also exists with dermatology, where the recalls are known as “airplane notes,” because residents write down as much as they can remember on the plane after taking the test.

In an anonymous e-mail to the American Board of Dermatology in 2008, a resident wrote: “The board needs to know that there is an organized effort year after year to, by verbatim, reproduce each and every question of the official ABD certifying examination minutes after its completion. So-called “airplane notes”…are well known to dermatology residents and are compiled, typed up and quietly distributed among residency programs across the country.”

The resident, now a practicing dermatologist, wrote, “Each year, minutes after the certifying exam is complete, there is an almost ceremonial meeting of examinees at a local hotel or restaurant there in Chicago. A feverish and collective effort is made by examinees from many programs to reproduce on paper as many questions as they can — verbatim — that they had just encountered. This is then integrated into an updated “airplane notes,” which then has questions from the year before, and the year before that, etc., in an organized fashion. These are even professionally bound at Kinko’s at times.”

In a response to the e-mail, the board’s executive director, Dr. Antoinette Hood, wrote: “The board takes every precaution to discourage this practice amongst graduating residents: maintaining strict security of items, minimizing the number of previously used questions, and requiring an honor code statement (signed two separate times) declaring that information will not be shared. Unfortunately we have no mechanism for enforcing the honor code or controlling interpersonal communications that occur after an examination. The real issue is how do we police professionalism and how do we identify the offenders?”

Hood said she has addressed this issue for several years during the board’s annual meeting by telling dermatology residents the practice is not allowed.

“I’ve never seen airplane notes, but I’ve heard about it,” Hood said.

“We really try to do something to prevent it from happening,” Hood said. “It’s a high stakes examination and people are naturally very anxious about it and that brings out the potential worst in people.”

Asked if she considered this cheating, Hood said, “Yes, but I can’t prove it – period.”

The board has warned residents that using airplane notes is illegal, because test questions are copyrighted.

“There are legal consequences to this practice, as the questions of the American Board of Dermatology are protected by copyright laws, and any reproduction, not approved by the board, illegal. But, of much greater importance, this practice is unethical and violates our professionalism and ethical standards, which are the basis for the trust given us by our patients,” one board newsletter obtained by CNN reads.

Dermatology residents confirm the practice has been widespread, but the value of the actual airplane notes varies depending on the accuracy of the memorization.

The dermatology board scrambles the approximately 300 questions from test to test to make it more difficult to memorize them. About 20% of the questions each year are recycled from old tests, compared with about 50% for the written exam in radiology.

“We scramble the questions so that discourages the rote memorization,” Hood said.

After a phone interview, Hood agreed to an an on-camera interview with CNN to discuss the recalls. But she abruptly canceled the interview two days beforehand, saying she had changed her mind.

While the use of airplane notes and recalls has been discussed for years in dermatology and radiology, they are not widely known outside those professions.

Dr. Gary Becker, executive director of the American Board of Radiology, said using recalls was cheating.

“I am saying it’s cheating. It’s a violation of our policy,” Becker said.

Dr. James Borgstede, the radiology board’s president-elect, said said the test-taking culture has changed since he took the exam in 1978.

“Right now, in radiology, jobs are hard to find. Board certification is very, very important. When I took the exam, you could still practice without being a board-certified radiologist. Now, that’s virtually impossible,” Borgstede said.

“So, a high-stakes examination, and the other thing is it’s a difference in culture. These individuals sort of view us as a system, and them as outside the system, and there’s this issue of sort of stick it to the man. You know, that we’re the system, and they can do this and it’s acceptable. We tell them it’s not acceptable.”

Becker said that despite the use of the recalls, the public is protected because of the overall training and an intensive oral exam that residents must undergo to become certified.

Next year, the board is rolling out a new exam for the first time in more than 10 years. Instead of two written tests and one oral exam, the first exam will be a “core exam” taken after three years of residency training, and the second certifying exam will be taken 15 months after graduation. The oral exam is being eliminated.

Meanwhile, The American College of Radiology, which does not certify radiologists, posted a statement on its website after the CNN story aired.

“The most troubling aspect of this report is the implication that all radiologists who pass these examinations are ‘cheaters.’ The allegation of cheating not only involves an unspecified and unidentified number of individuals, but smears the entire specialty with a broad and unjustified brush,” the statement said.

“Whether one considers the sharing of mentally recalled questions to be unethical, or simply a type of study aid, board certification represents significantly more than passing an exam, and should not be impugned simply on the basis of examination methodology,” it said.

Asked whether the group considered recalls cheating, a spokesman said it had no comment beyond the statement.

Other medical specialties contacted by CNN said they had not experienced that kind of systemic use of recalls.

The American Board of Family Medicine has sent investigators into test review company classes to ensure they aren’t teaching from old test questions.

“When we’ve investigated these groups and (gone) through these classes, we’ve never found old exams,” said board spokesman Robert Cattoi.

The board only re-uses “a very small number of questions” from old exams, he said. The American Board of Orthopedic Surgery re-uses about 20% of old questions each year.

“We know of no similar recall registry of questions such as was in your piece (about) the radiology residents,” said the board’s executive director, Dr. Shepard Hurwitz.

(CNN Health)

Article source: http://updatednews.ca/2012/02/03/doctors-cheating-in-dermatology-exams/

Cosmeceutical Experts Agree on Best Antiaging Products

The skin care market may pull in $9 billion per year, but three cosmeceutical experts agreed that the best over-the-counter antiaging products come down to two words: "moisturizer" and "sunscreen."

Speaking in separate presentations at the annual meeting of the American Society of Cosmetic Dermatology and Aesthetic Surgery (ASCDAS), Dr. Zoe D. Draelos, Dr. Ellen S. Marmur, and Dr. Michael H. Gold agreed that there is little science to back up claims made by cosmeceutical companies.

^{Sherry Boschert/Elsevier Global Medical News}

Dr. Zoe D. Draelos

Cosmeceuticals fall somewhere between cosmetics and pharmaceuticals; therefore, they are not regulated, and manufacturers are not required to show evidence of antiaging effectiveness. When evidence does exist, it generally points back to the moisturizer and sunscreen properties.

Dr. Draelos, a dermatologist in High Point, N.C., and a consulting professor of dermatology at Duke University in Durham, N.C., studied the ingredients in over-the-counter skin care products. She found that 80% of products are basically moisturizers that serve as a vehicle to deliver a high-profile ingredient being touted by the manufacturer (Plast. Reconstr. Surg. 2010;125:719-24).

Dr. Michael H. Gold

"Hands down, it’s the moisturizer" that’s the most important cosmeceutical choice, she said. "All the products that make antiaging claims are making moisturizer claims," and most antiaging products also have sunscreen ingredients in them.

Dr. Michael Gold said he has been dispensing cosmeceuticals for 22 years and has seen the market explode. "There is now a $700 moisturizer," he said. "There may be no difference" between that and a $10 moisturizer, "but some people will pay the $700 because it’s $700."

Dr. Gold, the founder and medical director of a skin care center based in Nashville, Tenn., urged his colleagues, "If you dispense, do it ethically."

Dermatologists have an important role to play by assessing the marketing claims of cosmeceuticals, not just listening to them. "Even though we don’t have a lot of good research right now, patients want something their doctor feels good about," said Dr. Marmur of Mount Sinai School of Medicine, New York, who is also president of the ASCDAS.

Dr. Ellen S. Marmur

She took that approach in her book, written with Gina Way, "Simple Skin Beauty: Every Woman’s Guide to a Lifetime of Healthy, Gorgeous Skin" (Atria Books, 2009). The book "perhaps put me at odds with some of the industry, but we’re challenging them to produce better science," she said.

Dr. Marmur and her associates are conducting the first independent, randomized, blinded, controlled trial comparing over-the-counter antiaging creams. With more than 130 subjects enrolled, the study will evaluate 28 biomarkers in seven lines of products, with the people who apply the products blinded to the product being used.

Not all antiaging cream manufacturers are included, however, "Some brands refused to participate" perhaps because they were afraid that the study would show that their product is effective but is a pharmaceutical, she said.

Dr. Draelos echoed that observation during a question-and-answer session. "The industry doesn’t want closer scrutiny," she said.

Article source: http://www.skinandallergynews.com/news/aesthetic-dermatology/single-article/cosmeceutical-experts-agree-on-best-antiaging-products/22ca504f3a.html