Human scalp hair: Modulation by various factors and hormones do estrogens inhibit or stimulate—A perplexing perspective

Summary

Several journal reports, reviews, and commentaries over the last 20‐25 years have pointed out the controversy attached to 17β‐estradiol's inhibitory or stimulatory influence on hair follicle growth/cycling citing rodent (murine) and human results. While 17β‐estradiol is the most potent sex steroid hormone in the body and has almost equal affinity for estrogen receptor (ER) alpha (α) and beta (β), there appears to be specific ER‐mediated effects on scalp hair follicles/growth, etc. Additionally, the newly discovered G protein‐coupled estrogen receptor (GPR30 or GPER) and the orphan receptor, estrogen‐related receptor (ERR) gamma (γ), in skin and other tissue sites have potential impacts of how estrogens via these receptors may alter scalp hair characteristics, but this remains to be elucidated. Conversely, the negative impact of the 5α‐reductase enzyme and its steroid product, 5α‐dihydrotestosterone, on scalp hair growth is clear. Less clear is how 17β‐estradiol is stimulatory in some scalp hair studies, but inhibitory in others. This brief summary examines the potential influences of steroidogenesis via aromatase (estrogen biosynthesis) and 5α‐reductase expression, their enzyme activities, and steroid products along with the concepts of how steroid acute regulatory protein (StAR) and estrone sulfate may be involved in the complex hormonal, cellular/molecular signaling cascade of the hair follicle in growth and cycling.

http://bit.ly/2tpUE6s

Lungensonografie für Anästhesie, Intensiv- und Notfallmedizin

Anästhesiol Intensivmed Notfallmed Schmerzther 2019; 54: 108-127
DOI: 10.1055/a-0664-5700

Die Lungensonografie ist in der Intensiv- und Notfallmedizin ein unterschätztes Werkzeug: Bei bestimmten klinischen Fragestellungen ist ihre Sensitivität drastisch höher als die der Röntgen-Thoraxuntersuchung 1. Ein standardisierter Untersuchungsgang verbessert dabei die Untersuchungsqualität 2. Dieser Artikel vermittelt Grundlagenwissen der Lungensonografie und stellt die Überlegenheit des Ultraschalls gegenüber Röntgenverfahren heraus.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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http://bit.ly/2UVObfc

Ultraschall in AINS

Anästhesiol Intensivmed Notfallmed Schmerzther 2019; 54: 88-89
DOI: 10.1055/a-0805-2279

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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http://bit.ly/2EcLiku

Extrakorporale kardiopulmonale Reanimation: Datenlage bis heute unklar

Anästhesiol Intensivmed Notfallmed Schmerzther 2019; 54: 85-86
DOI: 10.1055/a-0823-5785

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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http://bit.ly/2V1M5KJ

Kaffee, Kippe, Kaugummi – Mythen und Fakten zur präoperativen Nüchternheit

Anästhesiol Intensivmed Notfallmed Schmerzther 2019; 54: 142-145
DOI: 10.1055/s-0043-124943

Zur Reduktion des Aspirationsrisikos gelten strikte Vorgaben für präoperative Nüchternzeiten. Für klare Flüssigkeiten (2 Stunden) und feste Nahrung (6 Stunden) sind diese eindeutig definiert; der Einfluss von Kaffee, Rauchen und Kaugummi wird dagegen kontrovers diskutiert. Dieser Beitrag zeigt, welche Mythen zur präoperativen Nüchternheit bestehen und durch welche Fakten sich das Risiko verlässlich einordnen lässt.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

http://bit.ly/2Ef1Fxb

Driving Pressure – ein neuer/alter Parameter zur Beatmungsoptimierung?

Anästhesiol Intensivmed Notfallmed Schmerzther 2019; 54: 85-85
DOI: 10.1055/a-0823-5844

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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http://bit.ly/2UZXSZV

Die fokussierte transthorakale Echokardiografie in der perioperativen Versorgung

Anästhesiol Intensivmed Notfallmed Schmerzther 2019; 54: 90-106
DOI: 10.1055/a-0586-6146

Mithilfe der fokussierten transthorakalen Echokardiografie (TTE) erhalten wir rasch und nichtinvasiv aktuelle Informationen zum hämodynamischen Status eines Patienten. Diese können nachfolgend unsere aktuelle Therapie und dadurch unser Risikomanagement beeinflussen. Postoperativ hat sich die TTE als Untersuchungsmethode im Aufwachraum und auf der Intensivstation bewährt, um lebensbedrohliche Ursachen für eine Kreislaufdepression zeitnah zu diagnostizieren. Akutpathologika wie eine Perikardtamponade oder die fulminante Pulmonalarterienembolie können so schnell erfasst und evtl. auch zeitintensive Transporte in eine CT vermieden werden. Auch präoperativ kann der Einsatz der TTE sinnvoll sein zur Beurteilung des Volumenstatus, der Pumpfunktion oder hämodynamisch relevanter Vitien. Vor allem bei Operationen mit hohem perioperativem Komplikationsrisiko können diese Erkenntnisse mit in eine „goal-directed therapy" einfließen. Entsprechende Algorithmen für ein erweitertes hämodynamisches Monitoring und das Volumenmanagement existieren bereits in vielen Bereichen – sie werden aber häufig nicht konsequent umgesetzt und in die Abläufe der eigenen Klinik implementiert. Mit diesem Artikel legen wir Nutzen und Relevanz der hämodynamischen Evaluation mittels TTE in jeder Phase der Patientenversorgung dar. Darüber hinaus stellen wir einen möglichen Algorithmus für die Versorgung kritisch kranker Patienten vor, der auf den wichtigsten transthorakalen Untersuchungen und hämodynamischen Messverfahren basiert. Er soll im klinischen Alltag und insbesondere im Bereitschaftsdienst eine Hilfestellung für den sinnvollen Einsatz der TTE bieten.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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http://bit.ly/2EdNw38

Spinalanästhesie mit Chloroprocain 1% zeigt Vorteile bei ambulanten Arthroskopien

Anästhesiol Intensivmed Notfallmed Schmerzther 2019; 54: 86-87
DOI: 10.1055/a-0823-5577

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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http://bit.ly/2UZXM4v

Abdominelle Notfallsonografie in der Intensiv- und Akutmedizin

Anästhesiol Intensivmed Notfallmed Schmerzther 2019; 54: 128-141
DOI: 10.1055/a-0585-5237

Die sonografischen Untersuchungstechniken unterstützen die Point-of-Care-Diagnostik (POC-Diagnostik) bei akutmedizinischen Fragestellungen. Für den Intensiv- und Notfallmediziner gilt: Kenntnisse und Fertigkeiten einer fokussierten Sonografie sind unabdingbar. Dieser Artikel beleuchtet die Optionen der abdominellen Notfallsonografie und gibt praktische Hilfestellung.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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http://bit.ly/2Ed62sx

Gewalt in der Notfallmedizin – gegenwärtiger Stand in Deutschland

Anästhesiol Intensivmed Notfallmed Schmerzther 2019; 54: 146-154
DOI: 10.1055/s-0043-112189

Hintergrund In den letzten Jahren werden Mitarbeiter von Rettungsdiensten und Notaufnahmen immer häufiger Opfer von gewalttätigen Übergriffen während ihres Dienstes. Jedoch wird die Erfassung von Häufigkeiten, Arten, Ursachen, Täterprofilen sowie möglichen Lösungsansätzen und Schutzmaßnahmen in Deutschland bisher – im Vergleich zum angloamerikanischen Sprachraum – eher stiefmütterlich behandelt. Ziel Das Ziel dieser Arbeit war eine weitgehende Erfassung der bisher vorliegenden aktuellen Daten der letzten Jahre, um einen zusammenfassenden Überblick über die Situation in Deutschland geben zu können. Ergebnisse Es liegen nur sehr wenige Arbeiten aus Deutschland zu diesem Thema vor. Die gefundenen Arbeiten zeigten, dass Gewalt im Rettungsdienst und in der Notaufnahme nicht nur ein Problem im angloamerikanischen Sprachraum ist. Bis zu 90% der Studienteilnehmer einer Befragung von Rettungsdienstmitarbeitern und 75% der teilnehmenden Mitarbeiter aus Notaufnahmen gaben an, in den letzten Monaten vor der Befragung Opfer von verbaler und/oder physischer Gewalt geworden zu sein. Die Mehrheit der Studienteilnehmer (je nach Studie zwischen 60 und 80%) fühlt sich gar nicht bis unzureichend auf aggressives und gewalttätiges Verhalten vorbereitet und wünscht sich professionelle regelmäßige Weiterbildung in Deeskalationstechniken und Selbstverteidigung. Auch die ständige Anwesenheit von Sicherheitsdiensten wurde zur Verminderung gewaltsamer Übergriffe auf Mitarbeiter durch Studienteilnehmer als sinnvoll erachtet. Um konkretere Aussagen treffen zu können, bedarf es weiterer prospektiver Multicenterstudien.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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http://bit.ly/2UZXBWT

Massiver Informationsverlust bei Übergaben auf Intensivstation!

Anästhesiol Intensivmed Notfallmed Schmerzther 2019; 54: 84-85
DOI: 10.1055/a-0823-5728

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

http://bit.ly/2EdNtEu

Effects of channel morphology on nitrate retention in a headwater agricultural stream in Lake Chaohu Basin, China

Abstract

Five field tracer experiments and relevant detailed investigations of physical characterizations were conducted to investigate the effects of channel geomorphic settings on nitrate uptake efficiency on a 310-m long geomorphically distinct stream reach in a headwater agricultural stream in Hefei District, Lake Chaohu Basin. The model-fitted parameters from the one-dimensional transport with inflow and storage model were used to estimate the transient storage metric ( \( {F}_{\mathrm{med}}^{200} \) ) and determine the total nitrate uptake coefficient (k) for the study reach. And then, a nutrient spiraling approach was applied to reach-scale nitrate uptake estimates (S_w, V_f, and U). The results showed that the main channel was the major contributor to nitrate uptake retention, and the higher geomorphic complexity might result in better nitrate uptake efficiency. The partial least squares regression (PLSR) analysis showed strong correlations between the independent variables as geomorphic settings, Reynolds number and transient storage, and the dependent variables as nitrate uptake metrics, which further underscored the importance of stream physical characteristics on measurement of stream nitrate uptake.

http://bit.ly/2DJMieE

A novel nano zero-valent iron biomaterial for chromium (Cr 6+ to Cr 3+ ) reduction

Abstract

This research work aims to develop a biomaterial entrapped with iron nanoparticles by green synthesis method in which biomass act as both reducing and capping agent. Iron nanoparticles embedded in Citrus limetta peels were characterised using ICP-MS for determination of metal loading, XRD, XPS for crystallinity and oxidation states, TEM followed by FESEM-EDS for particle size and morphology. Sizes of nanoparticles were found to be in the range of 4–70 nm. Batch experiments were conducted to study the effect of different parameters such as contact time, amount of biomaterial and volume of chromium(VI) solution for 2500 mg L⁻¹ of Cr(VI). Complete reduction was attained for a contact time of 5 min with 1.5 g of biomaterial for initial concentration of 2500 mg L⁻¹. The experimental results inferred that 1 g of biomaterial completely reduced 33 mg of hexavalent Cr to trivalent Cr. XRD and XPS revealed that iron nanoparticles are in amorphous form while XPS confirms Fe⁰ state. The transition of Fe⁰ to Fe²⁺/Fe³⁺ during the treatment with chromium solution confirms the reduction of Cr⁶⁺ to Cr³⁺.

http://bit.ly/2SBHan1

Depression, anxiety-like behavior, and memory impairment in mice exposed to chitosan-coated zein nanoparticles

Abstract

The advent of biotechnology provided the synthesis of nanoproducts with diverse applications in the field of medicine, agriculture, food, among others. However, the toxicity of many nanoparticles (NP) currently used, which can penetrate natural systems and impact organisms, is not known. Thus, in this study, we evaluated whether the short exposure (5 days) to low concentrations of chitosan-coated zein nanoparticles (ZNP-CS) (0.2 ng/kg, 40 ng/kg, and 400.00 ng/kg) was capable of causing behavioral alterations compatible with cognitive deficit, as well as anxiety and depression-like behavior in Swiss mice. However, we observed an anxiogenic effect in the animals exposed to the highest ZNP-CS concentration (400.00 ng/kg), without locomotor alterations suggestive of sedation or hyperactivity in the elevated plus maze (EPM) test. We also observed that the ZNP-CS caused depressive-like behavior, indicated by the longer immobile time in the tail suspension test and the animals exposed to ZNP-CS presented deficit in recognition of the new object, not related to locomotor alteration in this test. To the best of our knowledge, this is the first report of the neurotoxicity of ZNP in a mammal animal model, contributing to the biological safety assessment of these nanocomposites.

http://bit.ly/2DGaezA

Preliminary report of microwave ablation for the primary papillary thyroid microcarcinoma: a large-cohort of 185 patients feasibility study

Abstract

Purpose

To assess the safety and efficacy of microwave ablation (MWA) for primary papillary thyroid microcarcinoma (PTMC) with a large sample of 185 patients.

Methods

A total of 185 patients underwent MWA for 206 primary PTMC nodules. They received ultrasound follow-up at 1, 3, 6, and 12 months after MWA and every 6 months thereafter. Nodule volumes were calculated at each follow-up and compared with those before MWA. Additionally, the volume reduction rate (VRR) of the nodules was calculated. Patients' thyroid functions were tested before and 1 month after MWA.

Results

The mean follow-up time of the 185 patients was 20.7 ± 8.8 months (range 12–36 months). During the follow-up period, the mean volume of the 206 nodules was 100.1 ± 92.9 mm³ (range 3.6–423.9) before MWA, which decreased to 2.2 ± 5.6 mm³ (range 0–20.3 mm³) after MWA (P = 0.000). The mean VRR of the nodules was 98.65 ± 3.60% after MWA (range 83.85–100%). One hundred and seventy four of 206 nodules (84.5%) were fully absorbed. Compared with the preoperative results, no significant variation in thyroid function was observed 1 month after MWA. Thirty-eight patients (20.5%) had different types of complications, ranging from minor to major. Five patients (2.7%) had hoarseness, 11 patients (5.9%) had bleeding, 21 patients (11.4%) had earache or toothache, and one patient had another lesion 1 month after MWA.

Conclusions

This preliminary study suggests that MWA is safe and effective in the treatment of primary PTMC and offers a new alternative for clinical treatment.

http://bit.ly/2X5CuV1

Preliminary report of microwave ablation for the primary papillary thyroid microcarcinoma: a large-cohort of 185 patients feasibility study

Abstract

Purpose

To assess the safety and efficacy of microwave ablation (MWA) for primary papillary thyroid microcarcinoma (PTMC) with a large sample of 185 patients.

Methods

A total of 185 patients underwent MWA for 206 primary PTMC nodules. They received ultrasound follow-up at 1, 3, 6, and 12 months after MWA and every 6 months thereafter. Nodule volumes were calculated at each follow-up and compared with those before MWA. Additionally, the volume reduction rate (VRR) of the nodules was calculated. Patients' thyroid functions were tested before and 1 month after MWA.

Results

The mean follow-up time of the 185 patients was 20.7 ± 8.8 months (range 12–36 months). During the follow-up period, the mean volume of the 206 nodules was 100.1 ± 92.9 mm³ (range 3.6–423.9) before MWA, which decreased to 2.2 ± 5.6 mm³ (range 0–20.3 mm³) after MWA (P = 0.000). The mean VRR of the nodules was 98.65 ± 3.60% after MWA (range 83.85–100%). One hundred and seventy four of 206 nodules (84.5%) were fully absorbed. Compared with the preoperative results, no significant variation in thyroid function was observed 1 month after MWA. Thirty-eight patients (20.5%) had different types of complications, ranging from minor to major. Five patients (2.7%) had hoarseness, 11 patients (5.9%) had bleeding, 21 patients (11.4%) had earache or toothache, and one patient had another lesion 1 month after MWA.

Conclusions

This preliminary study suggests that MWA is safe and effective in the treatment of primary PTMC and offers a new alternative for clinical treatment.

http://bit.ly/2X5CuV1

Detection of outliers in pollutant emissions from the Soto de Ribera coal-fired power plant using functional data analysis: a case study in northern Spain

Abstract

For more than a century, air pollution has been one of the most important environmental problems in cities. Pollution is a threat to human health and is responsible for many deaths every year all over the world. This paper deals with the topic of functional outlier detection. Functional analysis is a novel mathematical tool employed for the recognition of outliers. This methodology is applied here to the emissions of a coal-fired power plant. This research uses two different methods, called functional high-density region (HDR) boxplot and functional bagplot. Please note that functional bagplots were developed using bivariate bagplots as a starting point. Indeed, they are applied to the first two robust principal component scores. Both methodologies were applied for the detection of outliers in the time pollutant emission curves that were built using, as inputs, the discrete information available from an air quality monitoring data record station and the subsequent smoothing of this dataset for each pollutant. In this research, both new methodologies are tested to detect outliers in pollutant emissions performed over a long period of time in an urban area. These pollutant emissions have been treated in order to use them as vectors whose components are pollutant concentration values for each observation made. Note that although the recording of pollutant emissions is made in a discrete way, these methodologies use pollutants as curves, identifying the outliers by a comparison of curves rather than vectors. Then, the concept of outlier goes from being a point to a curve that employs the functional depth as the indicator of curve distance. In this study, it is applied to the detection of outliers in pollutant emissions from a coal-fired power plant located on the outskirts of the city of Oviedo, located in the north of Spain and capital of the Principality of Asturias. Also, strengths of the functional methods are explained.

http://bit.ly/2GLycwv

Management immunologischer Nebenwirkungen von Patienten, die mit Immun-Checkpoint-Inhibitoren behandelt werden: ASCO Clinical Practice Guideline Summary

http://bit.ly/2SHw6oE

Association and gene–gene interaction analyses for polymorphic variants in CTLA-4 and FOXP3 genes: role in susceptibility to autoimmune thyroid disease

Abstract

Purpose

Polymorphic variants of cytotoxic T-lymphocyte antigen-4 (CTLA-4) and forkhead box protein P3 (FOXP3) genes are implicated in dysregulated immune homeostasis and autoimmune disorders. We analyzed the association between CTLA-4 rs231775 and FOXP3 rs3761548, rs3761549 polymorphisms and predisposition to autoimmune thyroid disease (AITD), inclusive of Hashimoto's thyroiditis (HT) and Graves' disease (GD) in South-Indian population.

Methods

A total of 355 AITD subjects (comprising 275 HT and 80 GD) and 285 randomly selected age- and sex-matched control subjects were genotyped for the aforementioned polymorphisms by PCR-RFLP method.

Results

The rs231775 "G" allele was preponderant in HT and GD subjects when compared with controls and exerted a dominant influence on the susceptibility to HT (p = 0.009) and GD (p = 0.02), respectively. There was no allelic association of rs3761548 and rs3761549 polymorphisms with AITD susceptibility, albeit a significant difference in genotype distribution with respect to rs3761549. Haplotype analysis revealed an increased frequency of rs3761548 "C"–rs3761549 "T" in HT and GD subjects, thereby associating it with disease predisposition (p = 0.03). Epistatic interaction analysis by multifactor dimensionality reduction approach revealed redundancy between CTLA-4 and FOXP3 genes in influencing the susceptibility to AITD.

Conclusions

The genetic variation in CTLA-4 gene with reference to rs231775 polymorphism contributes to an increased predisposition to HT and GD. Also, in conjunction with FOXP3 gene variants it seems to influence the susceptibility to HT and GD respectively. The significance of these findings in combination with antithyroid antibody screening could plausibly contribute towards meticulous case-finding for effective treatment of HT and GD.

http://bit.ly/2SUEBM9

Association and gene–gene interaction analyses for polymorphic variants in CTLA-4 and FOXP3 genes: role in susceptibility to autoimmune thyroid disease

Abstract

Purpose

Polymorphic variants of cytotoxic T-lymphocyte antigen-4 (CTLA-4) and forkhead box protein P3 (FOXP3) genes are implicated in dysregulated immune homeostasis and autoimmune disorders. We analyzed the association between CTLA-4 rs231775 and FOXP3 rs3761548, rs3761549 polymorphisms and predisposition to autoimmune thyroid disease (AITD), inclusive of Hashimoto's thyroiditis (HT) and Graves' disease (GD) in South-Indian population.

Methods

A total of 355 AITD subjects (comprising 275 HT and 80 GD) and 285 randomly selected age- and sex-matched control subjects were genotyped for the aforementioned polymorphisms by PCR-RFLP method.

Results

The rs231775 "G" allele was preponderant in HT and GD subjects when compared with controls and exerted a dominant influence on the susceptibility to HT (p = 0.009) and GD (p = 0.02), respectively. There was no allelic association of rs3761548 and rs3761549 polymorphisms with AITD susceptibility, albeit a significant difference in genotype distribution with respect to rs3761549. Haplotype analysis revealed an increased frequency of rs3761548 "C"–rs3761549 "T" in HT and GD subjects, thereby associating it with disease predisposition (p = 0.03). Epistatic interaction analysis by multifactor dimensionality reduction approach revealed redundancy between CTLA-4 and FOXP3 genes in influencing the susceptibility to AITD.

Conclusions

The genetic variation in CTLA-4 gene with reference to rs231775 polymorphism contributes to an increased predisposition to HT and GD. Also, in conjunction with FOXP3 gene variants it seems to influence the susceptibility to HT and GD respectively. The significance of these findings in combination with antithyroid antibody screening could plausibly contribute towards meticulous case-finding for effective treatment of HT and GD.

http://bit.ly/2SUEBM9

The Use of 124-I-PET/CT Whole Body and Lesional Dosimetry in Differentiated Thyroid Cancer

Condition:   Thyroid Cancer
Interventions:   Drug: Thyrogen;   Radiation: I-131;   Radiation: I-124
Sponsor:   National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Recruiting

http://bit.ly/2GvCloS

A Single Center Study in Healthy Volunteers to Assess the Pharmacokinetics of AZD9977 When Administered Alone and With Itraconazole

Condition:   Heart Failure With Preserved Ejection Fraction (HFpEF)
Interventions:   Drug: AZD9977;   Drug: Itraconazole
Sponsor:   AstraZeneca
Not yet recruiting

http://bit.ly/2Ij5YLQ

Protein and Exercise to Counteract Frailty in Older Adults

Condition:   Physical Frailty
Interventions:   Other: Resistance training;   Other: High-protein diet;   Other: Recommendations
Sponsors:   University of Southern Denmark;   Metropolitan University College;   The Municipality of Odense, Denmark;   Arla Foods
Not yet recruiting

http://bit.ly/2GoF3fK

GP vs PF as Induction Chemotherapy Combined With CCRT for Locoregionally Advanced Nasopharyngeal Carcinoma

Conditions:   Nasopharyngeal Carcinoma;   Nasopharyngeal Neoplasms;   Nasopharyngeal Diseases;   Head and Neck Neoplasm
Interventions:   Drug: gemcitabine and cisplatin;   Drug: cisplatin and fluorouracil;   Radiation: IMRT;   Drug: cisplatin
Sponsors:   Sun Yat-sen University;   Affiliated Cancer Hospital & Institute of Guangzhou Medical University;   Guangdong General Hospital;   First Affiliated Hospital, Sun Yat-Sen University
Recruiting

http://bit.ly/2IgyAoT

FT500 as Monotherapy and in Combination With Immune Checkpoint Inhibitors in Subjects With Advanced Solid Tumors

Conditions:   Advanced Solid Tumors;   Lymphoma;   HER2 Positive;   Gastric Cancer;   Colorectal Cancer;   Head and Neck Cancer;   Squamous Cell Carcinoma;   EGFR Positive Solid Tumor;   HER2-positive Breast Cancer;   Hepatocellular Carcinoma;   Small Cell Lung Cancer;   Renal Cell Carcinoma;   Pancreas Cancer;   Melanoma;   NSCLC;   Urothelial Carcinoma;   Cervical Cancer;   Microsatellite Instability;   Merkel Cell Carcinoma
Interventions:   Drug: FT500;   Drug: Nivolumab;   Drug: Pembrolizumab;   Drug: Atezolizumab
Sponsor:   Fate Therapeutics
Not yet recruiting

http://bit.ly/2Grdcvr

A Study Evaluating Safety and Efficacy of Niraparib in Patients With Previously Treated Metastatic Esophageal/Gastroesophageal Junction/Proximal Gastric Adenocarcinoma

Conditions:   Esophageal Cancer;   Gastric Cancer;   Adenocarcinoma
Intervention:   Drug: Niraparib
Sponsors:   Shadia Jalal, MD;   Tesaro, Inc.;   Indiana University School of Medicine
Not yet recruiting

http://bit.ly/2IgyddZ

Juvenile polyautoimmunity in a rheumatology setting

Publication date: Available online 14 February 2019

Source: Autoimmunity Reviews

Author(s): Clara Malagón, Maria del Pilar Gomez, Catalina Mosquera, Camilo Vargas, Tatiana Gonzalez, Cristine Arango, Lorena Martin, Pilar Perez, Laura Amaya-Uribe, Nicolas Molano-Gonzalez, Juan-Manuel Anaya

Abstract

Overt polyautoimmunity (PolyA) corresponds to the presence of more than one well-defined autoimmune disease (AD) manifested clinically in a single patient. The current study aimed to describe the main characteristics of juvenile PolyA in a pediatric rheumatology setting and analyze the chronological aspects, index cases, familial autoimmunity, and clustering pattern. This was a cross-sectional and multicenter study in which 313 children with overt PolyA were included. Patients were systematically interviewed and their medical records reviewed using a questionnaire that sought information about demographic, clinical, immunological, and familial characteristics. A hierarchical cluster analysis was done to determine similarities between autoimmune diseases based on PolyA. PolyA occurred simultaneously in 138 (44%) patients. Multiple autoimmune syndrome was observed in 62 (19.8%) patients. There were 25 index diseases of which, systemic lupus erythematosus (SLE, n = 134, 42.8%), juvenile idiopathic arthritis (JIA, n = 40, 12.7%), Hashimoto's thyroiditis (HT, n = 24, 7.66%), immune thrombocytopenic purpura (ITP n = 20, 6.39%), antiphospholipid syndrome (APS, n = 15, 4.79%), and vitiligo (VIT, n = 15, 4.79%) were the most frequent and represented 79.23% of the total number of patients. Familial autoimmunity influenced PolyA. A high aggregation of autoimmunity was observed (λ_r = 3.5). Three main clusters were identified, of which SLE and APS were the most similar pair of diseases (based on the Jaccard index) followed by HT and JIA, which were related to ITP and Sjögren's syndrome. The third cluster was composed of localized scleroderma and VIT. Our findings may assist physicians to make an early diagnosis of this frequent condition. Pediatric patients with ADs should be systematically assessed for PolyA.

http://bit.ly/2GMegcz

The European registry on obstetric Antiphospholipid syndrome (EUROAPS): A survey of 1000 consecutive cases

Publication date: Available online 15 February 2019

Source: Autoimmunity Reviews

Author(s): Jaume Alijotas-Reig, Enrique Esteve-Valverde, R. Ferrer-Oliveras, L. Sáez-Comet, E. Lefkou, A. Mekinian, C. Belizna, A. Ruffatti, A. Tincani, L. Marozio, G. Espinosa, R. Cervera, S. de Carolis, O. Latino, E. LLurba, P.L. Meroni, C.B. Chighizola, M. Gerosa, V. Pengo, K. Lundelin

Abstract

Aim

To analyse the clinical features, laboratory data and foetal-maternal outcomes, and follow them up on a cohort of 1000 women with obstetric antiphospholipid syndrome (OAPS).

Methods

The European Registry of OAPS became a registry within the framework of the European Forum on Antiphospholipid Antibody projects and was placed on a website in June 2010. Thirty hospitals throughout Europe have collaborated to carry out this registry. Cases with obstetric complaints related to antiphospholipid antibodies (aPL) who tested positive for aPL at least twice were included prospectively and retrospectively. The seven-year survey results are reported.

Results

1000 women with 3553 episodes were included of which 2553 were historical and 1000 were latest episodes. All cases fulfilled the Sydney classification criteria. According to the laboratory categories, 292 (29.2%) were in category I, 357 (35.7%) in IIa, 224 (22.4%) in IIb and 127 (12.7%) in IIc. Miscarriages were the most prevalent clinical manifestation in 386 cases (38.6%). Moreover, the presence of early preeclampsia (PE) and early foetal growth restriction (FGR) appeared in 181 (18.1%) and 161 (16.1%), respectively. In this series, 448 (44.8%) women received the recommended OAPS treatment. Patients with recommended treatment had a good live-birth rate (85%), but worse results (72.4%) were obtained in patients with any treatment (low-dose aspirin (LDA) or low-molecular-weight heparin (LMWH) not on recommended schedule, while patients with no treatment showed a poor birth rate (49.6%).

Conclusion

In this series, recurrent miscarriage is the most frequent poor outcome. To avoid false-negative diagnoses, all laboratory category subsets were needed. OAPS cases have very good foetal-maternal outcomes when treated. Results suggest that we were able to improve our clinical practice to offer better treatment and outcomes to OAPS patients.

http://bit.ly/2toQEmI

Enhanced type I interferon gene signature in primary antiphospholipid syndrome: Association with earlier disease onset and preeclampsia

Publication date: Available online 14 February 2019

Source: Autoimmunity Reviews

Author(s): Michelle Remião Ugolini-Lopes, Giovana Tardin Torrezan, Ana Paula Rossi Gândara, Eloisa Helena Ribeiro Olivieri, Iana Souza Nascimento, Erika Okazaki, Eloisa Bonfá, Dirce Maria Carraro, Danieli Castro Oliveira de Andrade

Abstract

Objective

Recently, two studies demonstrated that a relevant percentage of primary antiphospholipid syndrome (PAPS) patients had an upregulation of interferon (IFN) genes. However, 20%–28% of these patients had anti-dsDNA, a highly specific systemic lupus erythematosus (SLE) autoantibody. This study aimed to determine the prevalence of the type I IFN signature in the peripheral blood mononuclear cells of PAPS patients without specific SLE autoantibodies and search for its clinical associations.

Methods

Fifty-three PAPS patients (Sydney's criteria) were consecutively selected and age-matched with 50 healthy controls. A third group of nonimmune-mediated thrombophilia patients was also included. The expression of 41 IFN-induced genes was analyzed using real time quantitative PCR. A principal component analysis determined which genes composed the IFN signature, and the z-score was calculated. An ROC curve defined the signature cut-off.

Results

Six genes remained in the IFN signature DNAJA1, IFIT5, IFI27, MX1, IFI6, and TYK2. The ROC cutoff was 3.9-fold (AUC = 0.706, S = 0.49, E = 0.86, PPV = 0.79, NPV = 0.61). The type I IFN signature was present in 49% of the patients with PAPS compared with 14.0% of the healthy controls and 17% of the nonimmune-mediated thrombophilia patients (p < .0001). The IFN signature was associated with a younger age at the first antiphospholipid syndrome event (p = .023) and with preeclampsia (p = .032).

Conclusion

Our results indicate that PAPS patients without lupus-specific antibodies have an enhanced type I IFN gene signature that is not observed in nonimmune-mediated thrombophilia. Also, this overexpression of type I IFN-regulated genes associated with an earlier onset of antiphospholipid syndrome event and preeclampsia.

http://bit.ly/2tosRmY

Lethal immunoglobulins: Autoantibodies and sudden cardiac death

Publication date: Available online 14 February 2019

Source: Autoimmunity Reviews

Author(s): Varvara A. Ryabkova, Yuri V. Shubik, Mikhail V. Erman, Leonid P. Churilov, Darja Kanduc, Yehuda Shoenfeld

Abstract

Sudden cardiac death (SCD) is an unexpected death due to cardiac causes that occurs in a short time period (generally within 1 h of symptom onset) in a person with known or unknown cardiac disease. Patients with cardiomyopathies, myocarditis, ischemic heart disease and cardiac channelopathies are at risk of SCD. However, a certain percentage of autopsy-negative cases of SCD in the young (<35 years) remain unexplained even after a post-mortem genetic testing. Autoantibodies against cardiac proteins may be potentially involved in the pathogenesis of different heart diseases and in the occurrence of unexplained SCD. In this review we analyze clinical and animal studies that elucidate the prevalence of these autoantibodies in patients with different cardiac diseases and their pathophysiological relevance. We propose a classification of the autoantibodies associated with heart diseases and focus on their molecular and cellular effects. Anti-beta adrenergic receptor antibodies and anti-muscarinic acetylcholine receptor antibodies affect myocardial electrophysiological properties and were reported to be the independent predictors of SCD in patients with different heart diseases. Autoimmune mechanism is proposed for cardiac-related adverse reactions following human papillomavirus (HPV) vaccination. The pentapeptid sharing between HPV's antigens, adrenergic receptors and muscarinic acetylcholine receptors supports this assumption. The dysregulating effects of the autoantibodies against calcium and potassium ion channels can be the basis for autoimmune phenocopies of genetic cardiac channelopathies, which are also associated with SCD.

http://bit.ly/2GKNt0m

The study of interactions between genome and exposome in the development of systemic lupus erythematosus

Publication date: Available online 14 February 2019

Source: Autoimmunity Reviews

Author(s): Henrik Christian Bidstrup Leffers, Theis Lange, Christopher Collins, Constance Jensina Ulff-Møller, Søren Jacobsen

Abstract

Systemic lupus erythematosus (SLE) is a systemic inflammatory autoimmune disease characterized by a broad spectrum of clinical and serological manifestations. This may reflect a complex and multifactorial etiology involving several identified genetic and environmental factors, though not explaining the full risk of SLE. Established SLE risk genotypes are either very rare or with modest effect sizes and twin studies indicate that other factors besides genetics must be operative in SLE etiology. The exposome comprises the cumulative environmental influences on an individual and associated biological responses through the lifespan. It has been demonstrated that exposure to silica, smoking and exogenous hormones candidate as environmental risk factors in SLE, while alcohol consumption seems to be protective. Very few studies have investigated potential gene-environment interactions to determine if some of the unexplained SLE risk is attributable hereto. Even less have focused on interactions between specific risk genotypes and environmental exposures relevant to SLE pathogenesis. Cohort and case-control studies may provide data to suggest such biological interactions and various statistical measures of interaction can indicate the magnitude of such. However, such studies do often have very large sample-size requirements and we suggest that the rarity of SLE to some extent can be compensated by increasing the ratio of controls. This review summarizes the current body of knowledge on gene-environment interactions in SLE. We argue for the prioritization of studies that comprise the increasing details available of the genome and exposome relevant to SLE as they have the potential to disclose new aspects of SLE pathogenesis including phenotype heterogeneity.

http://bit.ly/2GKV5QH

Clinical significance and immunobiology of IL-21 in autoimmunity

Publication date: Available online 14 February 2019

Source: Journal of Autoimmunity

Author(s): Di Long, Yongjian Chen, Haijing Wu, Ming Zhao, Qianjin Lu

Abstract

Interleukin-21 (IL-21), an autocrine cytokine predominantly produced by follicular helper T (Tfh) and T helper 17 (Th17) cells, has been proven to play an important role in the immune system, for example, by promoting proliferation and the development of Tfh and Th17 cells, balancing helper T cell subsets, inducing B cell generation and differentiation into plasma cells, and enhancing the production of immunoglobulin. These effects are mainly mediated by activation of the JAK/STAT, MAPK and PI3K pathways. Some IL-21 target genes, such as B lymphocyte induced maturation protein-1 (Blimp-1), suppressor of cytokine signaling (SOCS), CXCR5 and Bcl-6, play important roles in the immune response. Therefore, IL-21 has been linked to autoimmune diseases. Indeed, IL-21 levels are increased in the peripheral blood and tissues of patients with systematic lupus erythematosus (SLE), rheumatoid arthritis (RA), type 1 diabetes (T1D), immune thrombocytopenia (ITP), primary Sjogren's syndrome (pSS), autoimmune thyroid disease (AITD) and psoriasis. This increased IL-21 even positively associates with Tfh cells, plasma cells, autoantibodies and disease activity in SLE and RA. Additionally, IL-21 has been utilized as a therapeutic target in SLE, RA, T1D and psoriatic mouse models. Profoundly, clinical trials have shown safety and improvement in RA patients. However, tolerance and long-term pharmacodynamics effects with low bioavailability have been found in SLE patients. Therefore, this review aims to summarize the latest progress on IL-21 function and its signaling pathway and discuss the role of IL-21 in the pathogenesis of and therapy for autoimmune diseases, with the hope of providing potential therapeutic and diagnostic strategies for clinical use.

http://bit.ly/2EaNsB3

The functional neuroanatomy of musical memory in Alzheimer’s disease

Publication date: Available online 15 February 2019

Source: Cortex

Author(s): Catherine F. Slattery, Jennifer L. Agustus, Ross W. Paterson, Oliver McCallion, Alexander JM. Foulkes, Kirsty Macpherson, Amelia M. Carton, Emma Harding, Hannah L. Golden, Kankamol Jaisin, Catherine J. Mummery, Jonathan M. Schott, Jason D. Warren

Abstract

Background

Memory for music has attracted much recent interest in Alzheimer's disease but the underlying brain mechanisms have not been defined in patients directly. Here we addressed this issue in an Alzheimer's disease cohort using activation fMRI of two core musical memory systems.

Methods

We studied 34 patients with younger onset Alzheimer's disease led either by episodic memory decline (typical Alzheimer's disease) or by visuospatial impairment (posterior cortical atrophy) in relation to 19 age-matched healthy individuals. We designed a novel fMRI paradigm based on passive listening to melodies that were either previously familiar or unfamiliar (musical semantic memory) and either presented singly or repeated (incidental musical episodic memory).

Results

Both syndromic groups showed significant functional neuroanatomical alterations relative to the healthy control group. For musical semantic memory, disease-associated activation group differences were localised to right inferior frontal cortex (reduced activation in the group with memory-led Alzheimer's disease); while for incidental musical episodic memory, disease-associated activation group differences were localised to precuneus and posterior cingulate cortex (abnormally enhanced activation in the syndromic groups). In post-scan behavioural testing, both patient groups had a deficit of musical episodic memory relative to healthy controls whereas musical semantic memory was unimpaired.

Conclusions

Our findings define functional neuroanatomical substrates for the differential involvement of musical semantic and incidental episodic memory in major phenotypes of Alzheimer's disease. The complex dynamic profile of brain activation group differences observed suggests that musical memory may be an informative probe of neural network function in Alzheimer's disease. These findings may guide the development of future musical interventions in dementia.

http://bit.ly/2GtgluF

Stratifying clinical complexity of dermatology outpatient visits: validation of a pilot instrument

Publication date: Available online 14 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Rajini K. Murthy, Benjamin J. Kahn, Chao Zhang, Suephy C. Chen

Abstract

The United States population is aging and increasing in comorbidity, and patient care is accordingly growing increasingly complex. Complexity impacts patterns of resource consumption, adverse event and medical error rates, health-related quality of life, physician burnout, and more. Tools capturing complexity can be of benefit in the modern value-based reimbursement landscape and have been well-studied in specialties other than dermatology. In this paper, we describe the validation of a tool specific to outpatient dermatologic care that captures the complexity of clinical visit medical decision-making. We performed a cross-sectional retrospective study to determine the inter-rater reliability and face validity of the tool. By objectively grading a clinical encounter based on clinical complexity, there is increased awareness of opportunities to improve clinical care and the allocation of healthcare costs and resources within the dermatologic community can be better assessed.

http://bit.ly/2Gx8FrF

Peristomal pyoderma gangrenosum: an exceedingly rare and overdiagnosed entity?

Publication date: Available online 14 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Stephanie T. Le, Jenny Z. Wang, Claire Alexanian, Samantha Ellis, Yocasta C. Martinez-Alvarado, Stephanie Johng, Apra Sood, Emanual Maverakis

http://bit.ly/2IgAgPv

Skin cancer risk factors and screening among sexual minority and heterosexual women

Publication date: Available online 14 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Howa Yeung, Marissa L.H. Baranowski, Suephy C. Chen

http://bit.ly/2GpYJ2Z

Quantitative Analysis of Free Amino Acids and Urea Derived from Isolated Corneocytes of Healthy Young, Healthy Aged, and Diseased Skin

Background/Aims: Free amino acids (FAAs) and urea, present inside the corneocytes, can be important indicators of skin condition. However, due to the lack of a standard extraction protocol for FAAs from corneocytes, conflicting research results have been reported. Therefore, the purpose of this study was (1) to standardize the extraction protocol and (2) to investigate FAA profiles in healthy young and healthy old volunteers, as well as in psoriasis and atopic dermatitis patients. Methods: Skin samples were collected from four groups (healthy young, healthy old, and psoriasis and atopic dermatitis patients) with 5 volunteers per group. Corneocytes were isolated and examined microscopically. FAAs and urea were extracted from the isolated corneocytes, and their amounts were quantified using LC-ESI/MS/MS (after derivatization with Fmoc-Cl) and colorimetric methods, respectively. Results: The micrographs of the corneocytes showed no morphological features attributable to age or disease conditions. The highest and lowest concentrations of total FAAs and urea were observed in the healthy old group and the healthy young group, respectively. Unlike the other FAAs and urea, citrulline was found at a higher level in the healthy young group than in the disease groups. Conclusion: This study suggests that the levels of FAAs and urea in the skin are affected by age and skin conditions (healthy/diseased). However, further studies are needed to show the effects of different skin conditions on the levels of FAAs and urea.
Skin Pharmacol Physiol 2019;32:94–100

http://bit.ly/2SRQgLF

Cosmetics, Vol. 6, Pages 11: Alkenones, a Renewably Sourced, Biobased Wax as an SPF Booster for Organic Sunscreens

Cosmetics, Vol. 6, Pages 11: Alkenones, a Renewably Sourced, Biobased Wax as an SPF Booster for Organic Sunscreens

Cosmetics doi: 10.3390/cosmetics6010011

Authors: An Huynh Mariam S. Abou-Dahech Christopher M. Reddy Gregory W. O'Neil Mark Chandler Gabriella Baki

Sun exposure can affect the skin in various ways leading to short- and long-term consequences. Waxes are often used to optimize the rheological behavior of products and provide an even sunscreen film on the skin, which can boost the sun protection factor (SPF) of ultraviolet (UV) filters. In this study, a biobased wax, alkenones, sourced from commercially available and sustainable microalgae was evaluated as an SPF booster in sunscreens. Thirty-five sunscreens were formulated using three waxes and four organic liquid UV filters. Products were tested for pH, viscosity, spreadability, stability, as well as in vitro SPF and water resistance. Alkenones&rsquo; in vitro SPF boosting capacity was similar to beeswax and cetyl alcohol with three &ldquo;reef-safe&rdquo; UV filters. None of the waxes used provided significant water resistance, however, using film-former water resistance could be built into the products. A key finding is that alkenones increased the in vitro SPF without increasing apparent viscosity. All products had a skin-compatible pH and they all remained stable at 25 &deg;C for 10 weeks. Overall, the alkenones&rsquo; performance was comparable to those of the comparator waxes. Our in vitro results indicate that alkenones offer a sustainable, biobased, non-animal derived choice as an SPF booster for organic sunscreens.

http://bit.ly/2X36ZuG

Relationship between periodontal inflammation and calcium channel blockers induced gingival overgrowth—a cross-sectional study in a Japanese population

Abstract

Objectives

Periodontal inflammation is regarded as a risk factor for drug-induced gingival overgrowth (DIGO). In order to elucidate the involvement of periodontal inflammation in DIGO, the periodontal status of subjects who do not develop DIGO despite receiving causative drugs (non-responders) needs to be examined. Therefore, the aim of the present study which was a pilot study was to assess periodontal inflammatory variables in responders (calcium channel blocker induced-GO patients), non-responders, and patients who did not receive causative drugs (non-consumers).

Materials and methods

The following parameters were measured: (1) existence of gingival overgrowth, (2) number of teeth, (3) mean periodontal pocket depth (PPD), and (4) percentage of positive sites for bleeding on probing (BOP). The periodontal inflamed surface area (PISA) and periodontal epithelial surface area (PESA) and the PISA/PESA ratio which indicated the degree of periodontal inflammation in each patient were also used to evaluate periodontal inflammation.

Results

Thirteen responders, 32 non-responders, and 83 non-consumers were included in the analyses. The mean PPD, percentage of BOP, PESA, and PISA, and the PISA/PESA ratio were significantly higher in responders than in non-responders and non-consumers (p < 0.01). The BOP, PISA, and PISA/PESA ratio were significantly lower in non-responders than in non-consumers (p < 0.05). A positive correlation was found between PPD and age in non-consumers. On the other hand, a negative correlation was noted between PPD and age in non-responders.

Conclusions

Periodontal inflammation may be associated with the initiation of DIGO.

Clinical relevance

It could be speculated that periodontal therapy before the administration of calcium channel blockers may prevent the development of gingival overgrowth.

http://bit.ly/2TRjmIe

Do electrical current and laser therapies improve bone remodeling during an orthodontic treatment with corticotomy?

Abstract

Objectives

Evaluate the bone remodeling during orthodontic movement with corticotomy when submitted to low-intensity electrical stimulation application (microcurrent—MC) and low-level laser therapy (LLLT).

Material and methods

One hundred and fifty Wistar rats were divided into the following 5 groups: (C) submitted to tooth movement; (Cort) tooth movement/corticotomy; (Cort-L) tooth movement/corticotomy/laser AsGaAl 808 nm (4.96J/50s); (Cort-Mc) tooth movement/corticotomy/microcurrent (10 μA/5 min); (Cort-L-Mc) tooth movement/corticotomy and laser/microcurrent alternated. Inflammation, angiogenesis, and osteogenesis were evaluated in the periodontal ligament (PDL) and alveolar bone on the 7th, 14th, and 21st days of orthodontic movement.

Results

The quantification of inflammatory infiltrate, angiogenesis and expression of TGF-β1, VEGF, and collagen type I were favorably modulated by the application of therapies such as low-level laser therapy (LLLT), MC, or both combined. However, electrical stimulation increased fibroblasts, osteoclasts and RANK numbers, birefringent collagen fiber organization, and BMP-7 and IL-6 expression.

Conclusions

Low-level laser therapy (LLLT) and MC application both improved the process of bone remodeling during orthodontic treatment with corticotomy. Still, electrical current therapy promoted a more effective tooth displacement but presented expected root resorption similar to all experimental treatments.

Clinical relevance

It is important to know the effects of minimally invasive therapies on cellular and molecular elements involved in the bone remodeling of orthodontic treatment associated with corticotomy surgery, in order to reduce the adverse effects in the use of this technique and to establish a safer clinical routine.

http://bit.ly/2BCMRGS

Age estimation based on visual parameters of the skin of cadavers

Abstract

Background

Previous studies have reported relationships between various visual parameters of the skin and changes due to aging. Due to an increase in the discovery of unidentified bodies, the field of forensic medicine anticipates the development of a rapid method for estimating age. The present study measured various visual parameters of the skin in human remains and investigated the correlation between these parameters and age.

Materials and Methods

Skin images were taken of four body parts (cheek, chin, brachium, and thigh) of 414 forensic cases. We interpreted eight visual parameters of the skin (smoothness, roughness, texture, dullness, brightness, erythema, color phase, and sagging) from skin photograph images, and constructed three age‐prediction models, categorized by sex, postmortem interval, and age.

Results

Significant correlations were observed in the erythema of the cheek and chin, the roughness of the brachium, and the texture of the brachium and thigh among the visual parameters calculated in four body parts, using the three models. The root‐mean‐square errors, which indicate the precision of the three prediction models, were 13.06, 13.80, and 13.77. The only model that demonstrated a correlation with the visual parameters was sex (but not age or postmortem interval).

Conclusion

Similar to living subjects, we observed a correlation with age for a number of visual parameters. The parameters that correlate with age depend on whether the site being measured was exposed to sunlight. Age estimation based on visual parameters requires measurement of visual parameters for skin both exposed and not exposed to sunlight.

http://bit.ly/2SAyVrb

Instrumental and sensory methodologies to characterize the residual film of topical products applied to skin

Abstract

Background

The work is aimed at the development of a methodology to characterize the tactile properties of topical products during application. Specific attention was paid to the study of the residual properties left at the surface of the skin. This approach was interestingly used to better understand the formulation factors governing the skinfeel of topical preparations.

Materials and Methods

Cosmetic and pharmaceutical topical products were selected based on their various texture, galenic form (gel or emulsion), and composition (polymer used as texturing agent). Key texture attributes namely Firmness, Stickiness, Spreadability, and Amount of residue were objectively evaluated using sensory analysis. Additionally, texture analysis (compression test), rheology (flow test), and tribology (in vivo friction test) were carried out.

Results

Sensory evaluations highlighted a great diversity of tactile properties among products when applied to skin. For example, assessors perceived an important amount of residue left by emulsions whereas gels were not leaving any residue after application to the skin. These results were confirmed by in vivo tactile friction measurements with two distinct evolutions in time of the residual film properties.

Conclusion

The present investigation shows how the tactile properties of topical gels and emulsions are studied using complementary tests in order to understand and improve the skinfeel of topical preparations.

http://bit.ly/2DF90o9

Phacomatosis pigmentokeratotica: Postzygotic HRAS mutation with malignant degeneration of the sebaceous naevus

http://bit.ly/2BCmUqG

A Morel‐Lavallée lesion simulating acute bacterial skin infection

http://bit.ly/2TRewL5

Chronic leg ulcerations associated with livedoid vasculopathy successfully treated with rivaroxaban

http://bit.ly/2N60y5y

Asymptomatic erythematous hardened plaque on the scalp

http://bit.ly/2SSHjSm

Conceptual, Statistical and Clinical interpretation of results from A Systematic Review and Meta‐Analysis of Cryosurgery combined with Topical interventions for Actinic Keratosis

Abstract

Furthermore, when conducting meta‐analysis by pooling studies, the studies should be analysing the outcome of the same input effect (for ex. in a meta‐analysis regarding efficacy of two treatments A & B, you cannot pool the results of a cohort that received treatment A with one that received treatment B, even though the outcome of both cohorts is measured in terms of Risk Ratio). Heppt et al.'s meta‐analysis fails to comply with said point. In Fig.3 of Heppt et al.'s manuscript, we observe that studies assessing different treatments (5‐FU, Imiquinod, Ingenol Mebutate, Diclofenac and ALA‐PDT) have been pooled, to determine the overall Risk Ratio, which is incorrect.

This article is protected by copyright. All rights reserved.

http://bit.ly/2N7wW82

Meta‐analysis of three‐in‐one single capsule bismuth‐containing quadruple therapy for the eradication of Helicobacter pylori

Abstract

Background

Bismuth‐containing quadruple therapy has been suggested as first‐line and rescue alternative for Helicobacter pylori eradication. Our objective was to perform a meta‐analysis evaluating the efficacy and safety of single capsule Pylera^® (bismuth, metronidazole, and tetracycline) plus a proton‐pump inhibitor (PPI) in any line of treatment.

Methods

Studies were selected up to October 2018. Outcomes were eradication and adverse events (AEs) rates pooled using the generic inverse variance method.

Results

In total, 30 studies (6482 patients) were included in the systematic review. The intention‐to‐treat (ITT) efficacy was 90% (95% CI: 87%‐92%, 21 studies, I ² = 88%) in first‐line therapy, 89% (95% CI: 86%‐93%, 12 studies, I ² = 78%) in second‐line and 82% (95% CI: 78%‐87%, nine studies, I ² = 60%) in third‐line; with no differences by the type or dosage of PPI used. For metronidazole‐resistant infection, the ITT efficacy as first‐line therapy was 93% (95% CI: 90%‐96%, six studies, I ² = 0%). In second‐line therapies where patients had been previously treated with clarithromycin, the ITT efficacy was 90% (95% CI: 87%‐93%, 11 studies, I ² = 78%). The overall incidence of AEs was 43% (95% CI: 35%‐50%, 24 studies, I ² = 92%) and they were mostly mild. In nearly 3% of the cases, treatment was interrupted due to AEs.

Conclusions

A 10‐day treatment with Pylera^® achieved an effective eradication rate of approximately 90% both in first‐ and second‐line therapy. This applies regardless of the type and dose of the PPI, in patients with clarithromycin‐ or metronidazole‐resistant strains, and in those previously treated with clarithromycin.

http://bit.ly/2SPManr