EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, November 15, 2004
For more information: Please contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.

Studies from the November issue of the Archives of Dermatology, a theme issue on facial rejuvenation:

CO₂ LASER SKIN RESURFACING PROCEDURE IMPROVES THE LOOK OF PHOTODAMAGED SKIN

A procedure that uses a carbon dioxide laser passed over the surface of the skin, improves the look of skin that has been damaged by the sun. The study, involving 28 patients aged 48 to 78 years old, found that the laser resurfacing produced changes in the skin's composition and that it was "clearly efficacious in producing cosmetic improvements in patients' skin."

CONCENTRATION AND VOLUME OF BOTULINUM EXOTOXIN A MATTERS

Higher volume injections of botulinum exotoxin A at lower concentrations affects a larger area near the injection site. "In the present study, we saw an approximate 50 percent increase in area simply by increasing the volume five-fold. The results indicate that we can add another level of sophistication to the use of botulinum exotoxin A by varying levels of precision. To treat larger, confluent areas, such as the forehead, a larger volume can be used to achieve more spread," the authors write.

ADDING A STREAM OF COLD AIR TO LASER TREATMENT FOR WRINKLES MAKES PROCEDURE LESS PAINFUL

In patients undergoing treatment for facial wrinkles using a carbon dioxide laser, the pairing of a focused stream of cold air with the laser during treatment made the procedure less painful. Eight patients were treated in the study-half of each patient's face was treated with the carbon dioxide laser alone, and the other half was treated with the laser and cold-air cooling. "In summary, the present method of using air cooling along with single-pass CO₂ laser skin resurfacing is an effective technique," write the researchers. "Without exception, all patients felt that the treatment on the side that was cooled with air was much more pleasant."

ACNE SCARS DIMINISHED BY LASER TREATMENT

Acne scars, which are often permanent, can be reduced using the nonablative 1064-nm Q-switched Nd:YAG laser. Eleven patients with acne scars were treated with the laser during five treatment sessions at three-week intervals. The patients were assessed after three sessions, and at one, three and six months after the fifth treatment session. "In conclusion, this study demonstrated that the 1064-nm Nd:YAG laser provides a safe and effective non-invasive treatment for mild to moderate facial acne scarring. The results are long lasting and continue well beyond the last treatment, indicating ongoing collagen remodeling after completion of the laser treatment sessions."

For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, November 15, 2004
To contact William J. Binder, M.D., call 310/858-6749.

CUSTOM-BUILT FACIAL IMPLANTS HELPFUL FOR PATIENTS WITH HIV AND FACIAL WASTING SYNDROME

CHICAGO—Patients taking highly active antiretroviral therapy (HAART) for the treatment of HIV/AIDS often lose fatty tissues in the face as a result of treatment, making them appear gaunt and emaciated. Silicone facial implants can help these patients achieve a healthier appearance and fuller face, according to an article in the November/December issue of the Archives of Facial Plastic Surgery, one of the JAMA/Archives journals.

As patients with HIV live longer, they are beginning to seek surgical procedures to help improve their appearance caused by the disease and treatment, the article states. Traditionally, facial wasting syndrome has been treated using the patient's own fat, but frequent adjustments and additional procedures were often required. Custom designed implants tend to remain stable in their position after implantation and retain their original size and structure.

William J. Binder, M.D., of the University of California, Los Angeles, and David C. Bloom, M.D., of the University of Washington, Seattle, investigated the use of custom-designed facial implants in the treatment of 22 patients with facial wasting syndrome.

High resolution computer tomography (CT)-a procedure that scans the patient's face and allows physicians to create a three-dimensional model of the skull bones-as performed on each patient. Custom-made implants were sized and fitted before implantation using models created using the CT images.

The researchers write that "Overall, 22 patients had excellent aesthetic postoperative outcomes as determined by the patient and the surgeon. Fourteen of the 22 patients received custom implants for more severe midfacial changes, and eight patients received "off-the-shelf" submalar implants for midfacial conditions of moderate severity," the authors write.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, November 15, 2004
To contact David M. Nondahl, M.S., call Jon Sender at 608/265-1629.

SMOKING NOT LINKED TO HEARING LOSS

CHICAGO—Levels of cotinine, a substance created by the breakdown of nicotine in the body, does not appear to be linked to hearing loss, according to an article in the November issue of the Archives of Otolaryngology—Head & Neck Surgery, one of the JAMA/Archives journals.

According to the article, hearing loss is one of the most common conditions among adults 65 years and older. Several studies have linked cardiovascular disease with hearing loss, and others have shown that hearing loss may be affected by cigarette smoking, a known cardiovascular disease risk factor.

David M. Nondahl, M.S., of the University of Wisconsin-Madison, and colleagues investigated the relationship between levels of serum cotinine and hearing loss in 197 patients with new hearing loss and 394 patients without any hearing loss (aged 53-75 years) selected from the 2,800 participants in the five-year follow-up Epidemiology of Hearing Loss Study, 1998-2000. Serum cotinine levels were measured from blood samples obtained from the participants.

The researchers found no significant associations between serum cotinine levels and hearing loss. Among participants with hearing loss, 14 were current smokers, 96 were past smokers and 83 never smoked. Among participants with no hearing loss, 41 were current smokers, 183 were past smokers and 164 never smoked. Smoking information was not obtained for 10 participants.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, November 15, 2004
To contact Adelheid End, M.D., email: adelheid.end-pfuetzenreuter{at}meduniwien.ac.at.

SURVEY SUGGESTS MAJORITY OF WOMEN SURGEONS SATISFIED IN THEIR PROFESSION

CHICAGO—Fifty-seven percent of women surgeons in Austria reported being very satisfied or satisfied in their professional situation, according to an article in the November issue of Archives of Surgery, one of the JAMA/Archives journals.

According to background information in the article, the number of women surgeons is increasing globally. In 2000, the percentage of female medical students was 63 percent in Austria, with the percentage of female medical school graduates 54 percent. Approximately 37 percent of medical doctors in Austria are women, making up about 10 percent of all certified surgeons in general surgery. However, studies on women surgeons are rare in Europe.

Adelheid End, M.D., of the University of Vienna, Austria, and colleagues surveyed Austrian women surgeons of all surgical specialties, in order to examine current professional and social traits, and opinions. The response rate for the 164-item questionnaire was 58.7 percent (206 of 351). The average age of survey respondents was 39.4 years, with 115 women (56 percent) between the ages of 35 and 45 years. Sixty-six percent (n=136) had a significant other and ninety-seven of the women (n=47 percent) had at least one child.

The researchers found that 57 percent of respondents (n=117) were satisfied or very satisfied with their professional situation. Twenty-eight percent (n=58) of the surgeons were moderately satisfied, while 13 percent (n=27) were dissatisfied or very dissatisfied. When asked how well organized their department was, 25 percent (n=52) described their organization as being very good; 54 percent (n=111) as average; and 18 percent (n=37) as bad. Higher satisfaction was found in surgeons in subspecialties, certified surgeons, comparatively younger and older surgeons, surgeons working in facilities outside of the capital, and surgeons with a physician as a significant other.