Exudative

Background: Pleural tissue can be harvested either by means of closed biopsies, thoracoscopy or open surgical biopsies. Access to thoracoscopy and open surgical biopsies is limited in many parts of the world and closed biopsies are therefore the preferred initial investigation (Diacon et al., 2003) [6]. Aim of the study: This study aimed to compare the diagnostic efficiency of image-assisted ANPB with that of medical thoracoscopy in patients with exudative pleural effusion. Patients and methods: Forty patients with non-diagnosed exudative pleural effusions were recruited. All had a contrast-enhanced thoracic CT scan to assess pleural thickening. Patients were randomly stratified by baseline pleural thickening, to either image-assisted Abrams’ pleural biopsy (n = 20) or medical thoracoscopy biopsy (n = 20). Results: Diagnostic sensitivity of image-assisted ANPB for 20 patients (group I) was 75% (15/20), for group Ia was 60% (6/10), and for group Ib was 90% (9/10). Diagnostic sensitivity of thoracoscopy for 20 patients (group II) was 85% (17/20), for group IIa was 80% (8/10), and for group IIb was 90% (9/10). Conclusions: Image-assisted Abram-needle pleural biopsy is a primary alternative to thoracoscopy in exudative pleural effusions associated with pleural thickening

Stem cell therapy as a novel therapeutic intervention for resistant cases of alopecia areata and androgenetic alopecia

Background: Management of alopecia areata (AA) and androgenetic alopecia (AGA) is often challenging as patients may be resistant to currently available modalities of treatment. The use of stem cells may be a novel option for resistant cases. Objective: To evaluate the safety and efficacy of the use of autologous bone marrow derived mononuclear cells (including stem cells) as compared to follicular stems cells for the management of resistant cases of AA and AGA. Methods: This study included 40 patients (20 AA patients and 20 AGA patients), all patients were treated with a single session of intradermal injection of autologous stem cells (SCs) therapy. They were divided into four groups according to the applied modality [either autologous bone marrow derived mononuclear cells (bone marrow mononuclear cells [BMMCs] or autologous follicular stem cells [FSC]). Results: Six months after stem cell therapy (SCT) injection, there was a significant improvement, confirmed by immunostaining and digital dermoscopy. The mean improvement in all groups was “very good”. There was no significant difference between both methods in either type of alopecia. No serious adverse events were reported. Conclusion: Autologous BMMCs and FSC seem to be a safe tolerable and effective treatment for the management of both resistant AA and AGA