The aim is to share their ideas and field questions from the floor.

At the May 2013 session, Rep. Tim Huelskamp (KS-01), Rep. Raúl Labrador (ID-01), Rep. Jim Jordan (OH-04), Rep. Justin Amash (MI-03), Rep. Jim Bridenstine (OK-01), Rep. Ron DeSantis (FL-06), Rep. Thomas Massie (KY-04), Rep. Todd Rokita (IN-04), and Rep. Steve Scalise (LA-01).

Conversations With Conservatives in Washington DC. Photo: Randy Foreman, NewsBlaze Washington Correspondent

Rob Bluey of The Heritage Foundation acted as moderator.

The only media story sighted so far is from NewsBlaze Washington Correspondent, Randy Foreman. “Conversations With Conservatives After Explosive IRS Hearings.”

Foreman’s story highlighted the recent testimony of Lois Lerner, the tax exempt status chief for the IRS, who wasn’t saying much at all, other than pleading the fifth. Even so, the Representatives present thought she didn’t do that correctly, and might be called back.

Rep. Steve Scalise (LA) opined that the IRS have “proven they can’t be trusted with tax exempt forms, so how can they be trusted with Obamacare. That’s why we fought so hard to repeal Obamacare last week.”

Rep. Raul Labrador (ID) wasn’t happy with media coverage of the issue. He wants them to think about thinking “if this was Bush.” They only seemed to get some backbone when the Associated Press came into the firing line.

The Conversations With Conservatives also touched on Benghazi, and the recent Moore, Oklahoma EF-5 tornado. Rep. Jim Bridenstine (OK) said he “couldn’t be prouder” of the resourcefulness of Oklahomans. He also noted that Rep. Tom Cole is on the ground for residents displaced by the tornado.

Smash Mouth has sold more than 10 million albums worldwide and are best known for their number one hits, “Walkin’ on the Sun”, “All Star” and for their covers of The Monkees classics, “I’m a Believer” and “Can’t Get Enough of You Baby” which were featured on the Shrek soundtrack. Their fun, pop sensibility mixed with a 60’s garage band vibe will keep The Great American Barbeque & Beer Festival upbeat, family friendly and enjoyable for all.

Additionally, California based rock band, Hoobastank will perform a collection of their best hits mixed with songs from their new album, Fight or Flight. Hoobastank is best known for their hit “The Reason” which peaked at #2 on the Billboard Hot 100 in 2004.

On the local frequency stage, a dozen bands including Arizona’s own Bird City, Cartoon Lion, Versions of You, Good Rust, Ethan 103, We Were Strangers, Inept Hero, Moment of Ruin, We Are Searchers, Black Bottom Lighters and Howard Til’ Midnight will perform. Also, Cali-Reggae rock band, 80 Proof will bring their up tempo blend of reggae, rock, pop, blues and soul.

Other event highlights include themed activities, an expanded kid’s zone hosted by Radio Disney, eating competitions and much more. Some additions to the 2013 event include water activities, family friendly entertainment and more of what everyone comes for—BBQ & beer!

The Great American Barbeque & Beer Festival is shaping up to deliver Arizona’s biggest and most delicious BBQ event ever!

HDE Agency is pulling out all the stops this year with a massive event planned that includes over 100 exhibitors, and more than 30 BBQ vendors from across the nation serving up over 20,000 lbs of mouth-watering pork ribs, pulled pork, brisket and chicken paired with the state’s finest craft beer.

General admission tickets are $10 and that includes entry into the event at noon. For a limited time, VIP admission tickets are available through presale only at $98 each. VIP includes catered food by Porkopolis, alcoholic beverages, soft drinks, private restrooms, private seating and up front access to national headlining entertainment by Smash Mouth and Hoobastank.  VIP is for guests 21 years and older ONLY. Visit www.chandlerbbq.com to purchase presale and VIP tickets.

For more event information be sure to “like” this event on Facebook at www.facebook.com/bbq.beer.music and follow us on Twitter @BBQBEERFESTIVAL for entertainment announcements, a chance to win free tickets and more event details as they roll out.

The Great American Barbeque & Beer Festival official sponsors include Bashas’, Downtown Chandler Community Partnership, SanTan Brewing Company, BBQ Island, AZ BBQ Club, Local First AZ, Yelp, 98 KUPD, Porkopolis, Bulleit Bourbon, Woodcraft, Von Hanson’s Meats & Spirits, One Community, Food & Flourish, Phoenix Bites, Local Lily, ASU Gammage, White Water, UltraStar, and Dickel Bourbon who all remind you to enjoy BBQ and beer responsibly.

A portion of the event proceeds will benefit the Downtown Chandler Community Foundation (DCCF), a 501(c)(3) not-for-profit charitable foundation. The DCCF is responsible for the fundraising activities of the Downtown Chandler Community Partnership (DCCP). They provide a conduit for grants and sponsorships from public agencies, corporations, foundations and other sources for dissemination to the District and community organizations. For more information about the DCCF visit http://www.downtownchandler.org/downtown-chandler-community-foundation.

Researchers at the Mayo Clinic analyzed the additional costs of smoking and obesity among more than 30,000 Mayo Clinic employees and retirees. All had continuous health insurance coverage between 2001 and 2007.

The study, by James P. Moriarty  and his coauthors give new insight into the long-term costs of obesity and smoking, which both caused higher health costs in the seven-year follow-up period of the study.Their report shows obesity and smoking were both associated with excess costs for health care. In a comparison with nonsmokers, average health costs were $ 1,275 higher for smokers.

The incremental costs associated with obesity were even higher: $ 1,850 more than for normal-weight individuals. For those with morbid obesity, the excess costs were up to $ 5,500 per year.

The additional costs associated with obesity appeared lower after adjustment for other accompanying health problems (comorbidity). “This may lead to underestimation of the true incremental costs, since obesity is a risk factor for developing chronic conditions,” Moriarty and colleagues write.

Smoking and obesity place a growing strain on an already stretched healthcare system. Many employers are now evaluating wellness programs to lower their costs by reducing health risk factors.

eSOL a Japanese embedded software developer, has added superior real-time performance and high reliability to x86-based industrial, medical, and robotics devices.

With these enhancements, eSOL customers can accelerate development of applications based on high-end embedded processors including multi-core, with the scalable, multi-profiled real-time operating systems, that are tightly integrated with development tools and middleware components to create flexible development platforms

eSOL says its eCROS real-time OS-based software platform will now support the x86 CPU architecture. eCROS for x86 is scheduled to be released in the second quarter of 2012. By adopting eCROS for software development on x86 CPUs, including IntelR Atom? processors, developers will be able to incorporate the real-time capabilities and high reliability of the eT-Kernel real-time OS?the heart of eCROS. eT-Kernel also enables developers to reuse existing Linux software assets so that they can reduce costs and shorten development time. x86 processors and eCROS are the ideal combination for development of industrial, medical, and robotics devices, which require higher-level functions such as sophisticated GUIs and networking capabilities.

Many developers of such devices often build them on commercial off-the-shelf (COTS) single board computers. Developers frequently select x86 processors for these systems, not only because x86 processors can meet their stringent requirements, but also because x86-built-in single board computers from a variety of COTS vendors are available at reasonable prices. With easily accessible x86 hardware and eCROS, which fully integrates the eT-Kernel RTOS with middleware and development tools, developers can quickly start application software development.

eT-Kernel is used worldwide in many applications that require real-time performance and reliability, including car navigation systems, satellites, and other spacecraft. The eT-Kernel RTOS family consists of four scalable profiles. The top-of-the-line profile is eT-Kernel/POSIX, a POSIX-compliant RTOS. eT-Kernel/POSIX is highly compatible with Linux: several Linux software assets such as Android and Nokia’s Qt? application and UI framework have been quickly and successfully ported to eT-Kernel/POSIX with little modification. As a result of this compatibility, manufacturers are able to use Linux software and draw from thousands of Linux-trained engineers for x86-based software development.

eT-Kernel’s four profiles can be used for small-sized to large-scale, multifunctional systems. The eT-Kernel family includes eT-Kernel Multi-Core Edition for multi-core processors. eCROS incorporates eSOL’s eBinder development suite. eBinder’s tools and features designed specifically for RTOSes, help developers solve system issues quickly and optimize the OS for their projects.

“We believe developers of x86 systems will greatly benefit from our eCROS real-time OS-based integrated software platform,” said Nobuyuki Ueyama, Executive Vice President of eSOL. “Industrial, medical, and robotics devices in which x86 processors are widely used require the excellent real-time performance and high reliability that eT-Kernel provides. In addition to an integrated software platform, eSOL offers professional services to support developers of x86 systems as we do for users of ARM, SH, MIPS, and Power Architecture.”

A team of researchers, led by Sheela Sathyanarayana, MD, MPH, of Seattle Children’s Research Institute, have created a guide outlining exposure risks and reduction tips (see below) for some of the most common environmental toxins. The clinical opinion, “Environmental exposures: how to counsel preconception and prenatal patients in the clinical setting,” was published in advance online in the American Journal of Obstetrics & Gynecology.

“Reproductive health providers have an important role to play in counseling women on environmental health risks,” said Dr. Sathyanarayana of Seattle Children’s Research Institute and an assistant professor of pediatrics at the University of Washington. “Providers can be knowledgeable about these issues and empower patients to make positive decisions to reduce exposure and to prevent adverse health impacts to both mother and fetus.”

Reproductive health care providers should share these tips and more scientific information with women who want to become pregnant or who are pregnant.

• Remove your shoes at the door of your home to avoid tracking in pollutants.

• Decrease consumption of processed and canned foods.

• Avoid the use of plastics with recycling codes #3, #4 and #7.

• Don’t use chemical tick and flea collars or dips for pets.

The guidelines include evidence-based recommendations on how to talk with patients about environmental toxins like lead, mercury, pesticides and other endocrine-disrupting chemicals such as bisphenol A (BPA), which is used in a variety of products including canned food linings and cash register receipts. It also includes resources for each toxin area, outlining an easy and consistent way to deliver these important messages to women and their partners.

The guidelines contain helpful information for patients, too. “Women and their partners should be aware that pregnancy is an important time for development, that environmental chemicals can cause harm to a developing fetus, and that this topic is important to discuss with health care providers,” said Dr. Sathyanarayana. “There are simple ways to reduce exposures to lead, mercury, pesticides and endocrine-disrupting chemicals such as BPA by following the guidelines we have outlined,” she said.

Dr. Sathyanarayana’s co-authors include: Susan Buchanan, MD, MPH, University of Illinois at Chicago School of Public Health; Tanya Dailey, MD, Alpert Medical School of Brown University; and Judith Focareta, MED, RN, Magee-Womens Hospital of UPMC.

Additional Resources

“Environmental exposures: how to counsel preconception and prenatal patients in the clinical setting”: http://www.sciencedirect.com/science/article/pii/S0002937812001512?v=s5(The uncorrected, original manuscript is currently available for reference).
See the Environmental exposures slideshow

Environmental Exposures: Tips for Reproductive Health Care Providers, Preconception and Prenatal Women

Mercury
Risk factors: Exposure can come from eating fish, contact with quicksilver, and use of skin-lightening creams. Exposure during pregnancy can lead to adverse neurodevelopmental outcomes that include lower IQ, poor language and motor development.
Reducing exposure: Pregnant, preconception and breastfeeding women should follow U.S. Environmental Protection Agency and state-specific fish consumption guidelines. Avoid shark, swordfish, king mackerel, tile fish and large tuna.
Resources: http://www.doh.wa.gov/ehp/oehas/fish/fishchart.htm, http://www.nrdc.org/health/effects/mercury/guide.asp

Lead
Risk factors: Risk factors for exposure include recent immigration to the U.S., occupational exposure, imported cosmetics, and renovating or remodeling a home built before 1970. Lead is neurotoxic to a developing fetus.
Reducing exposure: Never eat nonfood items (clay, soil, pottery or paint chips); avoid jobs or hobbies that may involve lead exposure; stay away from repair, repainting, renovation and remodeling work conducted in homes built before 1978; eat a balanced diet with adequate intakes of iron and calcium; avoid cosmetics, food additives and medicines imported from overseas; and remove shoes at the door to prevent tracking in lead and other pollutants.
Resources: http://www.cdc.gov/nceh/lead/publications/leadandpregnancy2010.pdf, http://www.aapcc.org/dnn/AAPCC/FindLocalPoisonCenters.aspx

Pesticides
Risk factors: Exposure can come from eating some produce and from using pesticides in your home or on your pets. Exposure to pesticides in pregnancy has been shown to increase risk of intrauterine growth retardation, congenital anomalies, leukemia and poor performance on neurodevelopmental testing.
Reducing exposure: Do not use chemical tick and flea collars or dips; avoid application of pesticides indoors and outdoors; consider buying organic produce when possible; wash all fruits and vegetables before eating; and remove shoes at the door.
Resources: http://www.ewg.org/foodnews (focus on the “Dirty Dozen,” a list of the 12 most contaminated products published by the Environmental Working Group, http://www.spcpweb.org/resources/#factsheets

Endocrine-disrupting chemicals
Risk factors: Human prenatal phthalate exposure is associated with changes in male reproductive anatomy and behavioral changes primarily in young girls. Animal studies suggest prenatal exposure to BPA is associated with obesity, reproductive abnormalities and neurodevelopmental abnormalities in offspring. Endocrine-disrupting chemicals mimic or antagonize the effects of hormones in the endocrine system and can cause adverse health effects that can be passed on to future generations.
Reducing exposure: Decrease consumption of processed foods; increase fresh and/or frozen foods; reduce consumption of canned foods; avoid use of plastics with recycled codes #3, #4 and #7; be careful when removing old carpet because padding may contain chemicals; and use a vacuum machine fitted with a HEPA filter to get rid of dust that may contain chemicals.
Resources: http://www.niehs.nih.gov/news/sya/sya-bpa, http://www.atsdr.cdc.gov/toxprofiles/tp9-c1-b.pdf, http://www.epa.gov/oppt/pbde/

At the forefront of pediatric medical research, Seattle Children’s Research Institute is setting new standards in pediatric care and finding new cures for childhood diseases. Internationally recognized scientists and physicians at the Research Institute are advancing new discoveries in cancer, genetics, immunology, pathology, infectious disease, injury prevention and bioethics. With Seattle Children’s Hospital and Seattle Children’s Hospital Foundation, the Research Institute brings together the best minds in pediatric research to provide patients with the best care possible. Children’s serves as the primary teaching, clinical and research site for the Department of Pediatrics at the University of Washington School of Medicine, which consistently ranks as one of the best pediatric departments in the country. For more information, visit http://www.seattlechildrens.org/research.

The American Federation of Government Employees is launching a nationwide advertising campaign this weekend calling out Republican lawmakers for supporting a plan to pay for the payroll tax relief extension by slashing federal employee wages.

The new ads feature three federal employees from AFGE Locals representing Veterans Affairs nurses, Defense Department workers and federal corrections officers. Each of the employees asks GOP lawmakers to “explain it to me” how cutting federal pay and benefits helps put Americans back to work.

“I earn less than $ 45,000 a year. Explain it to me, GOP, how cutting my pay creates jobs,” says Paul Hoban of AFGE Local 1647, which represents employees at Tobyhanna Army Depot in Pennsylvania.

“Twelve percent of the salary I earn caring for veterans goes to my retirement. Explain it to me, GOP, how cutting my retirement puts people to work.” – Teresa Capecchi AFGE Local 3669,

“I pay more than $ 9,000 a year for family health insurance. Explain it to me, GOP, how cutting my take-home pay lowers unemployment.“- Eric Young AFGE Local 501

The 30-second television ad will premiere in the Washington area during the Sunday morning talk shows on ABC and CBS and will air Monday and Tuesday on CNN, Fox News and MSNBC. A full-page print ad will run in Monday’s Politico newspaper, which is distributed to every lawmaker on Capitol Hill. Versions of both ads also are being sent to AFGE locals to run in their local communities.

Republicans in Congress have proposed paying for the payroll tax relief extension by freezing federal employee salaries for another year.

“Federal employees already have given up their pay raises for two years in a row and many are in danger of losing their jobs because of drastic agency downsizing efforts,” AFGE National President John Gage said. “Freezing their wages for another year adds insult to injury and does nothing to get Americans back to work.”

Hundreds of AFGE members from every major federal agency and representing all 50 states will be in Washington for AFGE’s annual Legislative and Grassroots Mobilization Conference Feb. 12-15. Members will be meeting with their Congressional representatives during the week to address the attacks on federal employees’ pay, pensions and benefits.

The new ads build on the “Explain it to me, GOP” campaign that AFGE launched in December. A special website, www.ExplainItToMeGOP.org, has been created to share information regarding the issue. Copies of the ad can be viewed on this website.

The consensus was that modifying the EMV chip will be the foundation necessary to move to the next level of secure and convenient payments, whether in the form of contact, contactless and/or mobile.

The Summit is being held through February 10th at the Hilton Salt Lake City Center in Salt Lake City, Utah.

“The answer is simple: it’s time.” – Ed McLaughlin chief emerging payments officer MasterCard Worldwide

MasterCard recently revealed its road map, which includes the path for migration from magnetic stripe to EMV technology. Referring to EMV as “the foundation of the future of payments,” McLaughlin detailed MasterCard’s plans to encourage the rapid adoption of more secure contact and contactless chip cards by giving more benefits to merchants that invest in secure, dynamic authentication methods.

Visa’s Jennifer Fischer, head of U.S. payment system risk, agreed. She stressed that EMV’s dynamic authentication is critical for a more secure payments industry, maintaining that it will lay the groundwork for contact, contactless and mobile EMV under the same infrastructure. Visa guidelines promote an “always online” strategy that does not mandate offline authentication with PIN. Issuers have flexibility to choose cardholder verification options, whether it is online and/or offline PIN; signature; or no verification method.

The differing mobile wallet solutions emerging in the marketplace was a hot topic yesterday, with presenters commenting on consumers’ increasing use of mobile phones to compare prices, browse, and purchase. George Peabody, director of Mercator Advisory Group’s Emerging Technologies Advisory Service, called these consumers “weaponized shoppers.” Both MasterCard and Visa included mobile in their vision of the future of U.S. payments, while Isis and PayPal took the floor to talk commerce.

Isis director of sales Jim Stapleton announced that the company’s upcoming summer pilot in Salt Lake City will “transform the way people shop and pay.” Stapleton called the Isis mobile payment infrastructure — a joint venture formed by AT&T, T-Mobile and Verizon — a “convening of the industry” that gives banks and merchants “tinker toys” to develop payment and loyalty programs for customers in the form of a mobile wallet that is “safer than your other wallet.”

Patrick Gauthier, head of PayPal’s product strategy and business operations, retail services, focused on commerce and the consumer experience in his presentation. Citing that in the last few decades payments have driven commerce, Gauthier said that at least in the next 15 years, “commerce will drive what payments need to do.” He suggested that mobile wallet solution providers should roll out infrastructures and programs with merchants’ and consumers’ wants and needs in mind, as these are the parties that are going to drive usage.

Open Transit Payments

Several large U.S. transit agencies talked about their plans to move to open fare collection systems. All were looking to “future proof” systems, and all had aggressive implementation schedules. John McGee, SEPTA’s (Southeastern Pennsylvania Transportation Authority) chief officer of new payment technologies talked about their recent open payment system contract award, and their goal of a future where virtual ticketing plays a major role.

The Chicago Transit Authority (CTA), which recently awarded a $ 454 million contract to Cubic Transportation Systems, will skip pilots and aim for full implementation of its open payment system in the second quarter of 2014. Eric Reese, general manager of business development, said the main objective is to let consumers use the same payment mechanism across all of the CTA’s areas of service, adding, “NFC is a thought. When that time comes, we will be ready.”

The Metropolitan Transportation Authority (MTA) of New York is ready to commit to open payments as well. Amy Linden, the MTA’s senior director for new fare payment systems, said that their Tap & Ride™ project is about consumers being able to “buy fare products anytime, anywhere, and manage accounts anytime, anywhere.” With the goal to mainstream payments and leverage existing payment technologies and networks, Linden said the MTA aims to “go live” within three years of the design notice to proceed (NTP).

The results of the 4,000-plus-participant clinical study are being presented at the 32nd annual meeting of the Society for Maternal-Fetal Medicine in Dallas on Feb. 9, 2012. The study was recently published in the American Journal of Obstetrics & Gynecology.

In women having routine prenatal diagnosis, CMA detected additional genetic abnormalities in about 1 out of every 70 fetal samples that had a normal karyotype. When a birth defect was imaged by ultrasound, CMA found additional important genetic information in 6 percent of cases.

“These results suggest that CMA may soon replace karyotyping for prenatal testing.”  - Dr. Ronald Wapner Director Reproductive Genetics NewYork-Presbyterian Hospital

“Why would anyone want to continue to use the standard method, which gives only part of the answer?” says Dr. Wapner.

Wagner led the 34-center study funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

CMA is not routinely used for prenatal testing but has become the primary genetic test to evaluate newborns with birth defects, as well as infants and young children with developmental delays.

Dr. Wapner describes the observed difference in accuracy between the two tests this way: “With karyotyping, we can see only when pieces of the genome of about 5 million base pairs are missing from a chromosome. With CMA, we can see missing pieces of fewer than 100,000 base pairs.”

CMA is based on a method that determines whether the right amount of genetic material is present at numerous locations in the fetus’ genome.

This study was the first to examine the two methods in a blinded head-to-head comparison. Fetal samples were collected from the amniotic fluid or placenta of 4,450 participants. “These were women who were seeking prenatal testing for the usual reasons, which could be age, increased risk of inheritable disease, or a structural abnormality in the fetus,” Dr. Wapner says.

Each participant’s sample was split and sent, in a blinded fashion, to one of four laboratories that perform CMA – NewYork-Presbyterian Hospital/Columbia University Medical Center, Emory University, Baylor College of Medicine or Signature Genetics. The other portion of the sample was sent to Genzyme Genetics for standard karyotyping.

Results show that CMA and karyotyping were equally effective at identifying chromosomal abnormalities such as the duplicate chromosomes that cause Down syndrome and Trisomy 18. But CMA provided significantly more clinically relevant information in two situations.

“In 6 percent of the cases where there’s a structural abnormality of the fetus but karyotyping is normal, CMA will provide additional significant information,” Dr. Wapner says. “And in about 1.7 percent of cases where the procedure was done because of the mother’s age or similar concerns and the chromosomes were normal, CMA reveals additional information of concern.”

Both tests offer information on conditions that can be life-threatening to a newborn baby or that can signal a possible health threat that might be treatable. “We are looking for the same thing in both tests,” Dr. Wapner says. “But we find more abnormalities with CMA.”

CMA can identify at least 150 known conditions and tell us exactly what the problem is and what it means for a child. Although karyotyping provides the same kind of information, CMA will likely provide more information on other potential disorders that might not otherwise be picked up such as intellectual disability or autism.

“It does not always mean that a child will necessarily develop these disorders, because many are due to multiple influences,” Dr. Wapner says. “But it will help parents because they can be on the lookout for a particular disorder and have a treatment plan in place. I believe it is important to give parents as much information as they need about their child.”

“Wolfram|Alpha Pro is a major step forward for Wolfram|Alpha and the concept of computational knowledge.” – Stephen Wolfram Founder & CEO of Wolfram Alpha

“It is the single most important development for Wolfram|Alpha since the original website launched in 2009.” he announced

Wolfram|Alpha Pro emphasizes closer interaction between the user and the Wolfram|Alpha computational knowledge engine. A key feature is the ability to upload virtually any common kind of file or data for automatic analysis. Raw tabular data, images, audio, XML, and dozens of specialized scientific, medical, and mathematical formats are among the more than 60 formats currently supported by Wolfram|Alpha Pro.

“Our goal is to do what a top data scientist would do if given the user’s data — but to do it automatically in just a few seconds,” Wolfram added.

It also adds richer output to Wolfram|Alpha, automatically generating CDF (Computable Document Format) with interactive controls for animation and manipulation. In addition, users of Wolfram|Alpha Pro gain options for customizing graphical and tabular output for presentations and other purposes, and for downloading raw generated data in more than 60 formats.

Itincludes a host of other convenient new features, such as history, favorites, display options, whole-page download, and an on-screen keyboard for special technical symbols.

Free trial access to Wolfram|Alpha Pro is available immediately, with subscriptions starting at an introductory price of $ 4.99 per month, or $ 2.99 per month for students. Educational and site pricing are also available. The “standard” Wolfram|Alpha will remain free of charge to everyone, but only subscribers will have access to new Pro-level features and functionality.

More information is available at www.wolframalpha.com/pro.

However, they both affect a person’s skin, can be quite difficult to treat or remove and, now, dermatologists are discovering new laser therapies which enhance treatment for both conditions.

“Dermatologists are now finding that new laser therapies can significantly improve melasma and even remove tattoos more safely and effectively than laser procedures we have used in the past.” – Arielle N.B. Kauvar Clinical Professor Dermatology  New York University School of Medicine

Combination Laser Therapy Targets Melasma

Melasma is caused by an overproduction of melanin, a natural substance in the body that gives skin its color and can lead to dark patches on the face. While melasma may occur in anyone, the condition most commonly affects women with darker Mediterranean skin, Asians and Hispanics. Dr. Kauvar explained that melasma is typically controlled with topical medications that contain ingredients to lighten the skin, such as hydroquinone or retinoids.

However, this therapy may only provide temporary improvement in more difficult cases – particularly in patients with mixed-type melasma. In this type of melasma, excess pigment is produced in both the epidermis and dermis – the upper and lower levels of the skin. While high-energy lasers for pigment removal and laser resurfacing have been investigated to treat this type of melasma, Dr. Kauvar explained that the procedures were too harsh and could wound the skin, leading to increased pigment production and worsening of melasma. More recently, fractional lasers – which are less aggressive lasers – have been used, but there have been reports of an increased incidence of melasma recurring as well.

“Effective treatment of mixed-type melasma requires a very low-energy and low-impact procedure because irritation and inflammation can worsen melasma,” said Dr. Kauvar.

With the new combination therapy, the dermatologist performs a microdermabrasion immediately followed by a low-energy laser treatment with a Q-switched YAG laser. Patients then begin a topical regimen using hydroquinone and sunscreen.

In Dr. Kauvar’s study of 27 women with mixed-type melasma, 22 subjects (81 percent) experienced greater than 75 percent improvement of their melasma after an average of 2.6 laser treatments. Of those, 11 subjects (40 percent) achieved over 95 percent improvement of their melasma. In addition, she found that clearance of melasma was maintained for at least six months.

Tattoos Getting the Boot with New Laser Therapies

While lasers have been used to remove tattoos for several years, the procedure requires multiple treatment sessions (typically six to 10 treatments or more) and treatments are painful, requiring a few weeks of healing time between procedures. Dr. Kauvar noted that the process of tattoo ink removal is inefficient since every color of ink absorbs different wavelengths of light, requiring the use of multiple lasers. Some colors – such as yellow, orange, turquoise or fluorescent ones – remain more difficult to treat.

“Unfortunately, there is no ideal laser to remove all tattoo colors, but new approaches have recently been introduced that appear to produce better results with fewer treatment sessions,” said Dr. Kauvar.

These four separate treatments are administered at 20-minute intervals and have demonstrated much faster clearance of tattoo inks. Other research involves the use of the fractional ablative laser in conjunction with traditional tattoo-removal lasers to speed up clearance – resulting in as much as 50 percent tattoo ink removal in just one treatment session. In another new study, Dr. Kauvar is investigating the effectiveness of administering two treatments in one day using a combination of laser wavelengths to target different ink colors.

With this procedure, Dr. Kauvar first uses a Q-switched YAG laser on the tattoo, followed by a Q-switched alexandrite laser (which is better at treating blues and greens) 20 minutes after the first laser. Dr. Kauvar noted that initial results of this procedure have shown significant improvement in removing blue, green and black inks.