12 results
Dietary quality, as measured by the Alternative Healthy Eating Index for Pregnancy (AHEI-P), in couples planning their first pregnancy
- Pao Ying Hsiao, June L Fung, Diane C Mitchell, Terryl J Hartman, Marlene B Goldman
-
- Journal:
- Public Health Nutrition / Volume 22 / Issue 18 / December 2019
- Published online by Cambridge University Press:
- 27 May 2019, pp. 3385-3394
-
- Article
-
- You have access Access
- HTML
- Export citation
-
Objective:
Dietary quality (DQ), as assessed by the Alternative Healthy Eating Index for Pregnancy (AHEI-P), and conception and pregnancy outcomes were evaluated.
Design:In this prospective cohort study on couples planning their first pregnancy. Cox proportional hazards regression assessed the relationship between AHEI-P score and clinical pregnancy, live birth and pregnancy loss.
Setting:Participants were recruited from the Northeast region of the USA.
Participants: Healthy, nulliparous couples (females, n 132; males, n 131; one male did not enrol).
Results:There were eighty clinical pregnancies, of which sixty-nine resulted in live births and eleven were pregnancy losses. Mean (sd) female AHEI-P was 71·0 (13·7). Of those who achieved pregnancy, those in the highest tertile of AHEI-P had the greatest proportion of clinical pregnancies; however, this association was not statistically significant (P = 0·41). When the time it took to conceive was considered, females with the highest AHEI-P scores were 20 % and 14 % more likely to achieve clinical pregnancy (model 1: hazard ratio (HR) = 1·20; 95 % CI 0·66, 2·17) and live birth (model 1: HR = 1·14; 95 % CI 0·59, 2·20), respectively. Likelihood of achieving clinical pregnancy and live birth increased when the fully adjusted model, including male AHEI-P score, was examined (clinical pregnancy model 4: HR = 1·55; 95 % CI 0·71, 3·39; live birth model 4: HR = 1·36; 95 % CI 0·59, 3·13).
Conclusions:The present study is the first to examine AHEI-P score and achievement of clinical pregnancy. DQ was not significantly related to pregnancy outcomes, even after adjustments for covariates.
The impact of geographic range, sampling, ecology, and time on extinction risk in the volatile clade Graptoloida
- James Boyle, H. David Sheets, Shuang-Ye Wu, Daniel Goldman, Michael J. Melchin, Roger A. Cooper, Peter M. Sadler, Charles E. Mitchell
-
- Journal:
- Paleobiology / Volume 43 / Issue 1 / February 2017
- Published online by Cambridge University Press:
- 20 December 2016, pp. 85-113
-
- Article
- Export citation
-
Although extinction risk has been found to have a consistent negative relationship with geographic range across wide temporal and taxonomic scales, the effect has been difficult to disentangle from factors such as sampling, ecological niche, or clade. In addition, studies of extinction risk have focused on benthic invertebrates with less work on planktic taxa. We employed a global set of 1114 planktic graptolite species from the Ordovician to lower Devonian to analyze the predictive power of species’ traits and abiotic factors on extinction risk, combining general linear models (GLMs), partial least-squares regression (PLSR), and permutation tests. Factors included measures of geographic range, sampling, and graptolite-specific factors such as clade, biofacies affiliation, shallow water tolerance, and age cohorts split at the base of the Katian and Rhuddanian stages.
The percent variance in durations explained varied substantially between taxon subsets from 12% to 45%. Overall commonness, the correlated effects of geographic range and sampling, was the strongest, most consistent factor (12–30% variance explained), with clade and age cohort adding up to 18% and other factors <10%. Surprisingly, geographic range alone contributed little explanatory power (<5%). It is likely that this is a consequence of a nonlinear relationship between geographic range and extinction risk, wherein the largest reductions in extinction risk are gained from moderate expansion of small geographic ranges. Thus, even large differences in range size between graptolite species did not lead to a proportionate difference in extinction risk because of the large average ranges of these species. Finally, we emphasize that the common practice of determining the geographic range of taxa from the union of all occurrences over their duration poses a substantial risk of overestimating the geographic scope of the realized ecological niche and, thus, of further conflating sampling effects on observed duration with the biological effects of range size on extinction risk.
Revision of the Upper Ordovician graptolite Diplograptus (Amplexograptus) recurrens richmondensis Ruedemann
- D. Goldman, C. E. Mitchell
-
- Journal:
- Journal of Paleontology / Volume 65 / Issue 6 / November 1991
- Published online by Cambridge University Press:
- 20 May 2016, pp. 1016-1017
-
- Article
- Export citation
Morphology, systematics, and evolution of Middle Devonian Ambocoeliidae (Brachiopoda), western New York
- Daniel Goldman, Charles E. Mitchell
-
- Journal:
- Journal of Paleontology / Volume 64 / Issue 1 / January 1990
- Published online by Cambridge University Press:
- 20 May 2016, pp. 79-99
-
- Article
- Export citation
-
The internal morphology of ambocoeliid brachiopods from the Middle Devonian Hamilton Group of western New York indicates a need for several taxonomic revisions. “Ambocoelia” praeumbona is transferred to Emanuella. “Ambocoelia” spinosa and “A.” nana represent Crurispina n. gen. Specimens of species belonging to Crurispina have moderately well developed crural plates, and, accordingly, they are assigned to the subfamily Rhynchospiriferinae. Crural plates are small and obscure but clearly present in Ambocoelia umbonata, the type species of Ambocoelia. Thus, the diagnosis of the subfamily Ambocoeliinae is emended to include species with tiny crural plates.
Ambocoeliid specimens from the Levanna Shale Member of the Skaneateles Formation, formerly referred to Echinocoelia, reveal several elaborate features in the pedicle valve, including an apical plate and a hollow tube supported by a median septum. These specimens represent a new genus and species, Mucroclipeus eliei. The homeomorphy found in the shape and size of these ambocoeliids may be the result of paedomorphosis. Additionally, their pattern of occurrence and minute size suggest that they attained their paedomorphic state through progenesis. The taxa Ambocoelia tuberculata n. sp., Crurispina n. gen., and Mucroclipeus eliei n. gen. and sp. are established.
The stratigraphic distribution of graptolites in the classic upper Middle Ordovician Utica Shale of New York State: an evolutionary succession or a response to relative sea-level change?
- Daniel Goldman, Charles E. Mitchell, Michael P. Joy
-
- Journal:
- Paleobiology / Volume 25 / Issue 3 / Summer 1999
- Published online by Cambridge University Press:
- 08 April 2016, pp. 273-294
-
- Article
- Export citation
-
The stratigraphic distribution of graptoloid species within the upper Middle Ordovician strata of New York State represents a complex pattern of origination, extinction, faunal migration, and fluctuating relative abundances. In particular, the observed patterns of species turnover at graptolite biozone boundaries are apparently strongly correlated with lithofacies, sampling strategies, and the depositional effects of relative sea-level change.
Vertical facies changes that occur within third-order depositional sequences and fourth- or fifth-order parasequences are mirrored by changes in the graptoloid faunal composition. Large-scale faunal turnovers at biozone boundaries tend to occur either at sequence boundaries or at flooding surfaces within sequences (e.g., the base of Highstand System Tracts). The base of the Corynoides americanus and Climacograptus (D.) spiniferus Zones coincide with major onlap events, and the Orthograptus ruedemanni Zone fauna appears just below a Lowstand Systems Tract. Within individual biozones, smaller-scale changes such as the fluctuating relative abundances of graptoloid species coincide with higher-order parasequence cyclicity. These distribution patterns resemble recent computer-generated models for the sequence stratigraphic distribution of hypothetical taxa.
By combining good biogeographic control with a detailed sampling program, we are able to see through the patterns attributable to depositional cyclicity and identify the different components of faunal turnover (migration, speciation, and extinction).
Contributors
-
- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
-
- Book:
- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
-
- Chapter
- Export citation
177 - Histoplasmosis
- from Part XXII - Specific organisms: fungi
-
- By Mitchell Goldman, Indiana University School of Medical School, Alvaro Lapitz, Indiana University School of Medical School
- Edited by David Schlossberg, Temple University, Philadelphia
-
- Book:
- Clinical Infectious Disease
- Published online:
- 05 April 2015
- Print publication:
- 23 April 2015, pp 1134-1137
-
- Chapter
- Export citation
-
Summary
Introduction
Histoplasma capsulatum is a thermal dimorphic fungus found most frequently in soil in the midwestern United States. Bird and bat excreta rich in organic nitrogen support the growth of the fungus. Sites associated with blackbird roosts are the most common sources of outbreaks currently, whereas domestic chicken coops were a common source in the past. Recent outbreaks have occurred after cleaning a campsite contaminated by bat excreta, rototilling soil in a schoolyard below a bird roost, and digging for buried treasure. When sites are disturbed the spores become airborne, producing an infective aerosol. The lung is the portal of entry in almost every case of histoplasmosis. Spores of H. capsulatum are inhaled, and in the alveoli they convert to a yeast, the tissue-invasive form. The now multiplying yeasts are phagocytosed by alveolar macrophages that are initially incapable of killing the fungus. Ingested yeasts multiply inside macrophages and spread throughout the body via the lymphatics during the preimmune phase of the illness to organs rich in reticuloendothelial cells. Once adequate cell-mediated immunity (CMI) develops, the now “armed” macrophages can either kill or wall off the infecting organisms. Following a strong immune response, as is seen in immunocompetent individuals, necrosis occurs, which in time becomes calcified. These calcified granulomas are seen in the lung, hilar lymph nodes, liver, and spleen of individuals who successfully limited the infection.
Most individuals infected with H. capsulatum develop adequate CMI. If CMI fails to develop, progressive dissemination will occur.
Contributors
-
- By Dor Abrahamson, Jerry Andriessen, Roger Azevedo, Michael Baker, Ryan Baker, Sasha Barab, Carl Bereiter, Susan Bridges, Mario Carretero, Carol K. K. Chan, Clark A. Chinn, Paul Cobb, Allan Collins, Kevin Crowley, Elizabeth A. Davis, Chris Dede, Sharon J. Derry, Andrea A. diSessa, Michael Eisenberg, Yrjö Engeström, Noel Enyedy, Barry J. Fishman, Ricki Goldman, James G. Greeno, Erica Rosenfeld Halverson, Cindy E. Hmelo-Silver, Michael J. Jacobson, Sanna Järvelä, Yasmin B. Kafai, Yael Kali, Manu Kapur, Paul A. Kirschner, Karen Knutson, Timothy Koschmann, Joseph S. Krajcik, Carol D. Lee, Peter Lee, Robb Lindgren, Jingyan Lu, Richard E. Mayer, Naomi Miyake, Na’ilah Suad Nasir, Mitchell J. Nathan, Narcis Pares, Roy Pea, James W. Pellegrino, William R. Penuel, Palmyre Pierroux, Brian J. Reiser, K. Ann Renninger, Ann S. Rosebery, R. Keith Sawyer, Marlene Scardamalia, Anna Sfard, Mike Sharples, Kimberly M. Sheridan, Bruce L. Sherin, Namsoo Shin, George Siemens, Peter Smagorinsky, Nancy Butler Songer, James P. Spillane, Kurt Squire, Gerry Stahl, Constance Steinkuehler, Reed Stevens, Daniel Suthers, Iris Tabak, Beth Warren, Uri Wilensky, Philip H. Winne, Carmen Zahn
- Edited by R. Keith Sawyer, University of North Carolina, Chapel Hill
-
- Book:
- The Cambridge Handbook of the Learning Sciences
- Published online:
- 05 November 2014
- Print publication:
- 17 November 2014, pp xv-xviii
-
- Chapter
- Export citation
Chap. 52 - AMINOLEVULINIC ACID PHOTODYNAMIC THERAPY FOR FACIAL REJUVENATION AND ACNE
- from PART FOUR - COSMETIC APPLICATIONS OF LIGHT, RADIOFREQUENCY, AND ULTRASOUND ENERGY
- Edited by Sorin Eremia, University of California, Los Angeles, School of Medicine
-
- Book:
- Office-Based Cosmetic Procedures and Techniques
- Published online:
- 06 July 2010
- Print publication:
- 08 February 2010, pp 235-240
-
- Chapter
- Export citation
-
Summary
Light therapy is widely used in dermatology. The addition of a photosensitizing medication to the light, collectively known as photodynamic therapy (PDT), can enhance laser and light treatment. PDT has become an increasingly popular therapy for practitioners treating a variety of cosmetic and medical dermatologic conditions. The two commonly used photosensitizers are 20% 5-aminolevuline acid (ALA; Levulan, DUSA Pharmaceuticals) and the methyl ester of 20% 5-ALA (MAL; Metvixia, Galderma). Once ALA or MAL has been applied, it is metabolized into the photosensitizer protoporphyrin PpIX, which is preferentially taken up by rapidly proliferating cells such as tumor cells and sebaceous glands. Irradiation of photosensitized skin with various light and laser sources results in a photooxidation of the target molecules.
A variety of lasers and light sources have been utilized to activate ALA and MAL, including blue light (417 nm), red light (635 nm), pulse dye lasers (585 and 595 nm), and intense pulsed light (420–1200 nm). Table 52.1 demonstrates the absorption spectrum of PpIX and the corresponding PpIX absorbance of various light sources. Depending on the condition being treated, the PDT dose can be customized by controlling the amount of ALA/MAL that enters the skin, the time allowed for PpIX synthesis, the various laser and light sources, and the amount of light that is absorbed. This chapter will focus on the use of ALA-PDT for acne and photodamaged skin. Although currently off-label, its application for photorejuvenation and acne therapy is growing in use and popularity.
Chap. 42 - TREATMENT OF TELANGIECTASIA, POIKILODERMA, AND FACE AND LEG VEINS
- from PART FOUR - COSMETIC APPLICATIONS OF LIGHT, RADIOFREQUENCY, AND ULTRASOUND ENERGY
- Edited by Sorin Eremia, University of California, Los Angeles, School of Medicine
-
- Book:
- Office-Based Cosmetic Procedures and Techniques
- Published online:
- 06 July 2010
- Print publication:
- 08 February 2010, pp 189-200
-
- Chapter
- Export citation
-
Summary
Vascular lesions are one of the most common indications for laser therapy. While first and still commonly used for the treatment of port-wine stains and hemangiomas, this chapter will focus on their use for telangiectasias, facial veins, poikiloderma of Civatte, and leg veins. The most frequently used light devices for vascular lesions are the 532-nm potassium titanyl phosphate (KTP) and, more recently, diode laser; the 595-nm pulsed dye laser (PDL); the 1,064-nm Nd:YAG lasers; and the intense pulsed light (IPL) devices. Table 42.1 outlines the various vascular-specific laser and light-based systems. These systems work through selective photothermolysis with oxyhemoglobin (oxy-hb) as the target chromophore in vascular lesions. The absorption peaks for oxy-hb are 418 nm, 542 nm, and 577 nm. By targeting oxy-hb, pulses of energy are transferred to the surrounding vessel wall to selectively heat and destroy the abnormal blood vessels. The success of vascular lasers depends on their wavelength, pulse duration, and spot size as they relate to vessel depth and diameter:
The wavelength used needs to have sufficient penetration depth and selectivity for the target vasculature.
The pulse duration should be less than thermal relaxation time (TRT) to affect the intended target, while sparing surrounding structures. The TRT is the cooling time of the target and is proportional to the square of the vessel diameter. For example, a vessel 0.03 mm in size has a TRT of 0.86 ms, as compared to a 0.1 mm vessel, which has a 9.6-ms TRT. Longer pulse durations allow for slower heating of the target, which prevents rapid temperature spikes, which cause vessel wall rupture and purpura. When pulse durations exceed the TRT of the target structure, more heat diffuses outside the vessels, leading to unwanted thermal damage to surrounding tissue.
[…]
PART FOUR - COSMETIC APPLICATIONS OF LIGHT, RADIOFREQUENCY, AND ULTRASOUND ENERGY
- Edited by Sorin Eremia, University of California, Los Angeles, School of Medicine
-
- Book:
- Office-Based Cosmetic Procedures and Techniques
- Published online:
- 06 July 2010
- Print publication:
- 08 February 2010, pp 187-188
-
- Chapter
- Export citation
175 - Histoplasmosis
- from Part XXII - Specific Organisms – Fungi
-
- By Alvaro Lapitz, Indiana University School of Medicine, Mitchell Goldman, Indiana University School of Medicine, George A. Sarosi, Indiana University School of Medicine
- Edited by David Schlossberg
-
- Book:
- Clinical Infectious Disease
- Published online:
- 05 March 2013
- Print publication:
- 12 May 2008, pp 1211-1214
-
- Chapter
- Export citation
-
Summary
INTRODUCTION
Histoplasma capsulatum is a thermal dimorphic fungus found most frequently in soil in the midwestern United States. Bird and bat excreta rich in organic nitrogen support the growth of the fungus. Sites associated with blackbird roosts are the most commonly identified sources of outbreaks nowadays, whereas domestic chicken coops were the source of the fungus in the past. When sites are disturbed the spores become airborne, producing the infective aerosol. The lung is considered the portal of entry in almost every case of histoplasmosis. The spores of H. capsulatum are inhaled, and once in the alveoli they convert to a yeast, which is the tissue invasive form. The now multiplying yeasts are phagocytosed by alveolar macrophages that are initially incapable of killing the fungus. The ingested yeasts multiply inside the macrophages and are spread throughout the body via the lymphatics during the preimmune phase of the illness to organs rich in reticuloendothelial cells. Once adequate cell-mediated immunity (CMI) develops, the now “armed” macrophages can either kill or wall off the infecting organisms. When immunity is at a high level, as seen in normal individuals, necrosis occurs, which in time becomes calcified. These calcified granulomas are seen in the lung, hilar lymph nodes, liver, and spleen of individuals who successfully limited the infection.