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ive initial treatment of these patients justified. Nevertheless, low quality of included studies indicates further research to validate the outcomes of this review.

To date, there have been no satisfactory treatments to cure vulvar lichen sclerosus (LS). 5-Aminolevulinic acid photodynamic therapy (ALA-PDT) has been introduced in the treatment of vulvar lichen sclerosus (VLS), but no dermoscopic assessment has been conducted.

The included patients received six ALA-PDT sessions at 2-week intervals. After the third and sixth treatment, all patients were evaluated for clinical and dermoscopic variables with numeric scores assigned to each parameter.

Twenty-four VLS patiens were included in this study. Both primary objective signs (lesion size and depigmentation) and subjective symptoms (itching and burning pain) were improved remarkably after the third treatment, and further improvements were obtained after the sixth treatment. Among the dermoscopic variables, the early changes were the decreased score of bright white or white-yellowish structureless areas and the increased score of vessels, and further changes of these two dermoscopic features were observed after the sixth treatment. There were no changes in pink structureless areas, white shiny streaks, follicular plugs, brown structureless areas, purple dots, and erosions after the third treatment, but after the sixth treatment, the scores of these dermoscopic features decreased significantly except that the score of brown structureless areas increased siginificantly. There was no change in the score of peppering blue-gray dots. Both pain and erosions during the treatment could be tolerated.

ALA-PDT is effective for VLS. In addition, dermoscopic assessment may be more precise for indicating minute changes invisible to unaided eyes which are useful to monitor the response to treatments.

ALA-PDT is effective for VLS. In addition, dermoscopic assessment may be more precise for indicating minute changes invisible to unaided eyes which are useful to monitor the response to treatments.The aim of the present study is to describe a case report on the treatment of recurrent herpes using Photodynamic therapy (PDT) and Photobiomodulation as the treatments of choice. A 21-year-old white man checked in in the clinic for evaluation of vesicles arranged in the lower lip skin region. The clinical diagnosis was recurrent herpes and, for treatment, PDT was chosen, using 0.1% methylene blue as a photosensitizer and a pre-irradiation time of five minutes. The Therapy XT laser was used, with a wavelength of 660 nm, power of 100 mW, in a spot area of 0.028 cm², using 4 J energy per point, having been applied on 4 points, one in the center of the lesion and three on its laterals, so that it involved the entire extension of the lesion, totaling 16 J. After 24 hours after the application of the PDT, the patient returned for photobiomodulation with a low-power laser with a wavelength of 660 nm, power of 100 mW, using energy of 1 J per point, for 10 s, being applied on 4 points, totaling 4 J. It was possible to observe complete healing after 10 days of treatment, and the patient remains in follow-up for eight months without any recurrences.

The aim of the present study was to evaluate the bond integrity of bioactive cement (BA

) in contrast to conventional cement Calibra (C) after dentin treated with different surface conditioners (PDT, EYL, ECL) MATERIALS AND METHODS Sixty non-carious permanent mandibular molars were disinfected and embedded in acrylic resin till cement-o-enamel junction. For homogeneity the buccal surface were grounded and polished. Samples were categorized into three main groups based on conditioning technique. Samples in group 1 and 2 dentin conditioned with Er,CrYSGG (ECL), group 3 and 4 surface treated with ErYAG (EYL) and group 5 and 6 treated with photodynamic therapy (PDT).On conditioned surface bonding agent was applied and light cured. Samples from group 1,3,5 were bonded to Calibra (C). Whereas, specimens in group 2,4,6 were conditioned with bioactive cement (BA

) and subjected to ageing followed by shear bond strength testing (SBS) in universal testing machine. To detect significance difference between means of different groups analysis of variance (ANOVA) was performed followed by Tukey's post-hoc tests.

The maximum SBS was displayed in group 1, dentin conditioned with ECL and bonded to C (20.23 ± 0.47 MPa). Whereas, group 6, PDT of dentin to BA

demonstrated lowest bond integrity among experimental groups (12.97 ± 0.25 MPa). Bond strength of group 1, ECL-C (21.55 ± 3.08 MPa) and group 3 EYL-C (19.11 ± 0.65 MPa) were comparable (p > 0.05). Group 5 samples treated with PDT, MB-C (13.41±0.32 MPa) and group 6, MB-BA

(12.97 ± 0.25 MPa) were also comparable (p > 0.05) CONCLUSION BAc bonded to dentin after surface conditioning with ECL, EYL and PDT presented lower SBS in comparison to conventional cement C. Further studies are required to extrapolate the current findings.

 0.05) CONCLUSION BAc bonded to dentin after surface conditioning with ECL, EYL and PDT presented lower SBS in comparison to conventional cement C. Further studies are required to extrapolate the current findings.

Severe growth hormone deficiency causes lean body mass loss in male adolescents and increased fat mass in both sexes. The changes appear after a 6month GH pause.

The aim was to examine bone density and structure changes in adolescents with severe GHD during a 6-month rhGH treatment interruption.

In total, 113 adolescents (20 females) paused rhGH treatment for 6months at near-final height, and they were retested with arginine-GHRH challenge and basal IGF-1. Severe GHD was diagnosed in 19 individuals (5 females, GH peak <16ng/ml and IGF-1<-1.9 SDS) and excluded in 94 (15 females). Bone density and structure were measured by pQCT of the forearm and DXA of the total body at cessation of rhGH and 6months later.

In severe adolescent GHD (sGHD) patients, trabecular density (mg/cm

) decreased from 214 to 202 (p<0.01); changes in the adolescents with normal test results (tGHD) were from 221 to 214 (p<0.05). Cortical density (mg/cm

) increased from 1077 to 1099 (p<0.01) in sGHD patients and frotrimental to the bone.

The study aimed to cross-culturally adapt and validate the First-Time Fathers Questionnaire (FTFQ) in the cultural context of China.

Prospective validation study.

The study was conducted in four public hospitals in Hangzhou, a southeast coastal city of China.

Four hundred and nineteen first-time fathers (mean age=30.45 years, SD=3.44, range 22-46) whose partners had given birth between July 20 and October 10, 2019.

The instrument "First Time Fathers Questionnaire (FTFQ)" was translated and culturally adapted to the Chinese context according to the methodological criteria of the International Society for Pharmacoeconomic and Outcomes Research. The construct-related validity of the instrument was tested through EFA and CFA. Content validity was evaluated with an analysis of the expert judgment. Reliability was assessed based on the internal consistency.

Four domains were identified "Worry", "Information", "Emotional Support", and "Acceptance", with 19 items and adequate internal reliability (0.86, 0.80, 0.86, and 0.72, respectively) and a total variance of 64.65%. The CFA model showed there is a good fit for the data X

/df =1.20; RMSA=0.03; CFI=0.99; and NFI=0.93. Additionally, each item achieved an I-CVI ≧0.83, and the S-CVI/Ave=0.90.

The Chinese version of the FTFQ is a valid and reliable instrument to assess first-time fathers' experience of childbirth in China.

This study provides a validated questionnaire that is suitable for the Chinese cultural context. It contributes to the knowledge of first-time fathers' experience of childbirth and facilitate further actions to improve paternal satisfaction and behavior as labour companion.

This study provides a validated questionnaire that is suitable for the Chinese cultural context. It contributes to the knowledge of first-time fathers' experience of childbirth and facilitate further actions to improve paternal satisfaction and behavior as labour companion.

The 2011 and 2016 Stillbirth Lancet series made a call to action to identify mechanisms to reduce stillbirth stigma. This research answers that call, investigating the extent and dimensions of stillbirth stigma experienced by an international sample of mothers bereaved by stillbirth.

To determine the prevalence and type as well as explore explanatory variables associated with higher levels of stillbirth stigma with bereaved mothers in high-income countries (Australia, United Kingdom, The United States of America and New Zealand).

An international survey of 889 bereaved mothers was conducted utilising the recently developed Stillbirth Stigma Scale to explore the extent and types of stigma experienced, as well as the association between stigma and self-esteem (Rosenberg Self- Esteem Scales), perinatal grief (Perinatal Grief Scale), and perceived social support (Perceived Social Support Scale). Demographic information (e.g. age, education, stillbirth history, sexual orientation and mental health) were colled mothers.

This study is the first to demonstrate the prevalence, extent, type and explanatory variables of stigma reported by bereaved mothers and the association between this and poorer outcomes including increased grief and decreased self-esteem. This study begins a dialogue about prevalence and explanatory variables of stillbirth stigma and its impact, to inform future prevention and support potential stigma reduction programs for community and bereaved mothers.

Childbirth self-efficacy is an important indicator of a woman's choice of mode of delivery, and has been found to be closely related to adverse perinatal outcomes. This study was conducted to evaluate childbirth self-efficacy and its influencing factors among pregnant Chinese women.

A multicenter cross-sectional study.

Pregnant women were recruited by using a convenience sample in four maternal and child healthcare hospitals, one each from four cities in China between May and June 2018. Women with a singleton pregnancy, aged 18 years and older, and able to read and write the Chinese language were included. Trained investigators used a structured self-administrated questionnaire to collect data. EpiData 3.1 was used to prepare the database, and SAS 9.2 was used for statistical analysis. A one-way ANOVA test or independent sample t-tests were used to test the between-group differences in childbirth self-efficacy scores, as appropriate. Multivariate linear regression analyses were conducted to examine chilfrequently exercised, had some prenatal education, and had better self-rated health showed higher childbirth self-efficacy during pregnancy. Interventions concentrating on improving childbirth self-efficacy in China should focus on prenatal education for expectant mothers, and more attention should be given to pregnant women who are older, obese, are less physically active, and are in poor health.

Childbirth self-efficacy was low among pregnant Chinese women. Women with older age, higher BMI, and worse self-rated health status had lower childbirth self-efficacy. On the other hand, women who frequently exercised, had some prenatal education, and had better self-rated health showed higher childbirth self-efficacy during pregnancy. Interventions concentrating on improving childbirth self-efficacy in China should focus on prenatal education for expectant mothers, and more attention should be given to pregnant women who are older, obese, are less physically active, and are in poor health.