Clinical and Experimental Dermatology, EarlyView.
Τρίτη 2 Οκτωβρίου 2018
Sporadic pemphigus foliaceus and class II human leucocyte antigen allele associations in the white British and Indo‐Asian populations in the UK
Phytohormones enhanced drought tolerance in plants: a coping strategy
Abstract
Drought stress is a severe environmental constraint among the emerging problems. Plants are highly vulnerable to drought stress and a severe decrease in yield was recorded in the last few decades. So, it is highly desirable to understand the mechanism of drought tolerance in plants and consequently enhance the tolerance against drought stress. Phytohormones are known to play vital roles in regulating various phenomenons in plants to acclimatize to varying drought environment. Abscisic acid (ABA) is considered the main hormone which intensifies drought tolerance in plants through various morpho-physiological and molecular processes including stomata regulation, root development, and initiation of ABA-dependent pathway. In addition, jasmonic acid (JA), salicylic acid (SA) ethylene (ET), auxins (IAA), gibberellins (GAs), cytokinins (CKs), and brassinosteroids (BRs) are also very important phytohormones to congregate the challenges of drought stress. However, these hormones are usually cross talk with each other to increase the survival of plants in drought conditions. On the other hand, the transgenic approach is currently the most accepted technique to engineer the genes responsible for the synthesis of phytohormones in drought stress response. Our present review highlights the regulatory circuits of phytohormones in drought tolerance mechanism.
Co-contamination of antibiotics and metals in peri-urban agricultural soils and source identification
Abstract
To identify the dominant sources of contamination in peri-urban land, this study investigated the concentrations and distributions of antibiotics and metals in agricultural soil of this area. An index of landscape development intensity (LDI) was used to characterize the distribution of human disturbance-related land use. The results showed that total antibiotic concentration in the soil reached 395.55 μg/kg and that chlortetracycline was the predominant antibiotic compound, with a relatively high mean concentration of 30.62 μg/kg. In soils, the mean concentrations of Cu, Zn, and Pb were 38.41, 127.88, and 56.61 mg/kg and those of Al, Fe, and K were 83.73, 24.17, and 23.42 g/kg, respectively. A redundancy analysis showed that the landscape pattern in a 300-m buffer zone can well explain the variation in the concentrations of antibiotics and metals (24%, p < 0.05). The LDI in the 300-m buffer zone significantly correlated with the concentrations of total antibiotics and total amounts of Cu and Zn in the soil, suggesting that the risk of soil contamination increases with the intensity of anthropogenic activities. A structural equation modeling analysis indicated that Al, Cu, and Zn could significantly aggravate accumulation of tetracycline antibiotics in the soil, whereas there were only significantly direct paths from Cu to ciprofloxacin and norfloxacin. Overall, the results showed that aggravated co-contamination of antibiotics and metals occurs in agricultural soil under intensive human disturbance.
Keratosis Pilaris Rubra with Mucin Deposition
Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.
Assessment of elemental composition and properties of copper smelter-affected dust and its nano- and micron size fractions
Abstract
A comprehensive approach has been developed to the assessment of composition and properties of atmospherically deposited dust in the area affected by a copper smelter. The approach is based on the analysis of initial dust samples, dynamic leaching of water soluble fractions in a rotating coiled column (RCC) followed by the determination of recovered elements and characterization of size, morphology and elemental composition of nano-, submicron, and micron par ticles of dust separated using field-flow fractionation in a RCC. Three separated size fractions of dust (<0.2, 0.2–2, and >2 μm) were characterized by static light scattering and scanning electron microscopy, whereupon the fractions were analyzed by ICP-AES and ICP-MS (after digestion). It has been evaluated that toxic elements, which are characteristics for copper smelter emissions (As, Cu, Zn), are accumulated in fraction >2 μm. At the same time, up to 2.4, 3.1, 8.2, 6.7 g/kg of As, Cu, Zn, Pb, correspondently, were found in nanoparticles (<0.2 μm). It has been also shown that some trace elements (Sn, Sb, Ag, Bi, and Tl) are accumulated in fraction <0.2, and their content in this fraction may be one order of magnitude higher than that in the fraction >2 μm, or the bulk sample. It may be assumed that Sn, Sb, Ag, Bi, Tl compounds are adsorbed onto the finest dust particles as compared to As, Cu, Zn compounds, which are directly emitted from the copper smelter as microparticles.
Factors associated with false‐negative pathologic diagnosis of calciphylaxis
Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.
Investigation of high‐frequency hearing loss and outer hair cell function of the cochlea in patients with psoriasis: a case–control study
Clinical and Experimental Dermatology, EarlyView.
Efficacy of localized hand and foot phototherapy: a review of patients treated in a teaching hospital setting
Clinical and Experimental Dermatology, EarlyView.
Differential expression of interferon‐induced genes and other tissue‐based biomarkers in acute graft‐versus‐host disease vs. lupus erythematosus in skin
Clinical and Experimental Dermatology, EarlyView.
Public engagement lectures targeting prospective medical students: an opportunity for dermatology
Clinical and Experimental Dermatology, EarlyView.
Risk factors for development of systemic lupus erythematosus in patients with cutaneous lupus: a retrospective review
Clinical and Experimental Dermatology, EarlyView.
Cutaneous hyperpigmentation and familial gastrointestinal stromal tumour associated with KIT mutation
Clinical and Experimental Dermatology, EarlyView.
Acitretin as a successful treatment for Hailey–Hailey disease
Clinical and Experimental Dermatology, EarlyView.
The nose as the predominant site for pemphigus foliaceous
Clinical and Experimental Dermatology, EarlyView.
Systematic review and meta‐analysis of prevalence of dermatological toxicities associated with vemurafenib treatment in patients with melanoma
Clinical and Experimental Dermatology, EarlyView.
Penile necrobiosis lipoidica: case report and literature review
Clinical and Experimental Dermatology, EarlyView.
Cutaneous chromoblastomycosis effectively treated with local heat monotherapy
Clinical and Experimental Dermatology, EarlyView.
Homocysteine plasma levels in patients affected by hidradenitis suppurativa: an Italian experience
Clinical and Experimental Dermatology, EarlyView.
Effect of platelet‐rich plasma on proliferation and migration in human dermal fibroblasts
Journal of Cosmetic Dermatology, EarlyView.
Effectiveness of short‐pulse width Nd:YAG in laser hair reduction
Journal of Cosmetic Dermatology, EarlyView.
Low‐fluence Q‐switched Nd:YAG laser for the treatment of melasma in Asian patients
Journal of Cosmetic Dermatology, EarlyView.
Skin surface lipid differences in sensitive skin caused by psychological stress and distinguished by support vector machine
Journal of Cosmetic Dermatology, EarlyView.
Hypereosinophilia successfully treated with the novel antihistamine bilastine
Clinical and Experimental Dermatology, EarlyView.
Competitive adsorption and desorption of arsenate, vanadate, and molybdate onto the low-cost adsorbent materials alum water treatment sludge and bauxite
Abstract
When low-cost adsorbents are being used to remove contaminant ions (e.g. arsenate, vanadate, and molybdate) from wastewater, competitive adsorption/desorption are central processes determining their removal efficiency. Competitive adsorption of As, V, and Mo was investigated using equimolar oxyanion concentrations in single, binary, and tertiary combinations in adsorption isotherm and pH envelope studies while desorption of previously adsorbed oxyanions was examined in solutions containing single and binary oxyanion combinations. The low-cost adsorbent materials used were alum water treatment sludge (amorphous hydroxy-Al) and bauxite ore (crystalline Al oxides). Adsorption isotherm and pH envelope studies showed that Mo had only a small effect in decreasing adsorption of As and V but V and As had substantial and similar effects in reducing adsorption of the other. As had a greater effect than V in reducing adsorption of Mo and it was concluded that the affinity of oxyanions for the surfaces of water treatment sludge and bauxite followed the order As > V >> Mo. In 0.3 M NaCl electrolyte, desorption of previously adsorbed oxyanions amounted to 0.3–3.4% for V and As, and 11–20% for Mo. As had approximately four times greater effect than Mo in increasing desorption of V while V had about three times the effect of Mo in increasing desorption of As. Thus, the order of oxyanions in inducing desorption of the other oxyanions (i.e. As on V and As) was the same as that for adsorption selectivity: As > V >> Mo. Water treatment sludge was a more effective adsorbent than bauxite because it had a greater adsorption capacity for all three anions and, in addition, they were held more strongly so desorption in the background electrolyte was proportionately less. It was concluded that at similar molar concentrations, arsenate would tend to reduce adsorption of vanadate as well as displace vanadate already held on adsorbent surfaces while both anions will compete effectively with molybdate. The limiting factor for simultaneous removal of As, V, and Mo from multielement solutions by adsorption will therefore be the removal of Mo.
Sublethal effects of chronic exposure to CdO or PbO nanoparticles or their binary mixture on the honey bee ( Apis millefera L.)
Abstract
Cadmium and lead-based nanotechnologies are increasingly used in agricultural, industrial, and biological processes; however, potential adverse effects of nanomaterials on honey bees had not been assessed. In this study, effects of exposures to sublethal concentrations of PbO and CdO nanoparticles (NPs), either separately or in combination on honey bee (Apis mellifera) workers, were assessed. Honey bee workers were orally exposed for 9 days under laboratory conditions to sublethal concentrations (20% of LC50) of CdO (0.01 mg/ml−) and PbO (0.65 mg/ml−) NPs either separately or combined. Effects on survival, feeding rate, activity of acetylcholinesterase (AChE), and expression of selected stress-related detoxifying enzymes were quantified. Survival and feeding rates decreased particularly in bees fed sugar syrup containing CdO NPs or binary mixtures of NPs of both metal oxides. Expressions of genes involved in detoxification of xenobiotics were affected by various combinations. Expression of catalase was 13.6-fold greater in bees consumed sugar syrup diet containing binary mixture of sublethal concentrations of both CdO and PbO NPs than it was in unexposed, control bees. AChE activity in heads of honey bees was inhibited by 3.8-, 3.0-, and 2.8-fold relative to control, respectively, in response to exposure to Cd or/and Pb oxide NPs. This result indicates potential neurotoxic effects of these NPs to honey bees. CdO NPs exhibited greater potency to honey bees. Overall, sublethal concentrations of CdO or/and PbO NPs resulted in detrimental effects on honeybee workers.
Association of benzene exposure with insulin resistance, SOD, and MDA as markers of oxidative stress in children and adolescents
Abstract
Benzene is a ubiquitous environmental pollutant with various health effects. It is reported that benzene exposure might be associated with insulin resistance in elderly adults. The aim of this study is to investigate the association between urinary benzene metabolite, trans, trans-muconic acid (t,t-ma) and markers of oxidative stress and insulin resistance in children and adolescents. This cross-sectional study was conducted in 2017 among 86 children and adolescents, aged 6–18 years, living in Isfahan, Iran. t,t-ma was measured as urinary benzene metabolite and homeostasis model assessment (HOMA-IR) was determined as an index of insulin resistance. Moreover, malondialdehyde (MDA) and superoxide dismutase (SOD) were assessed as oxidative stress markers. We found significant association between insulin resistance, fasting blood glucose, and fasting blood insulin with t,t-ma (p values = 0.002, 0.03, and 0.001, respectively). Results of this study indicate that benzene metabolite in higher concentrations in comparison with lower concentrations is associated with increased risk of insulin resistance. Moreover, after adjustment for age, sex, and household passive smoking, statistically significant increase were documented in SOD and MDA (4.49- and 3.54-fold, respectively) in intermediate levels of t,t-ma vs. low levels of t,t-ma (p values = 0.01 and 0.034, respectively). To the best of our knowledge, this is the first study in its kind in the pediatric age group. It showed that benzene exposures, even in environmental levels, might be associated with insulin resistance and oxidative stress in children and adolescents. Further longitudinal studies are necessary to assess the clinical impacts of this finding.
Biomechanical response of a submerged, rosette-forming macrophyte to wave action in a eutrophic lake on the Yungui Plateau, China
Abstract
Few studies have focused on the biomechanical responses of submerged, rosette-forming macrophytes to wave action, water depth, or their co-occurrence in naturally eutrophic systems. The plant architecture, root anchorage strength-related traits, leaf morphology, and biomechanics of Vallisneria natans inhabiting a range of water depths were examined along three transects (T1, T2, and T3) in a eutrophic lake, Lake Erhai, in Yunnan Province, China. These transects were exposed to weak wave action and hyper-eutrophication (T1), moderate wave action and eutrophication (T2), or strong wave action and eutrophication (T3). The results showed that V. natans was mainly distributed at intermediate depths, with the widest colonization depth in T1. The values of plant architecture, root anchorage strength-related traits, leaf morphology, and biomechanics were generally highest in T3 and smallest in T2. Along the depth gradient, these values were generally highest at 3.5, 2.5, and 2.5 m for the plants growing in T1, T2, and T3, respectively. These findings suggest that V. natans adopts a "tolerance" strategy to cope with the effects of strong wave action in eutrophic habitats and an "avoidance" strategy when exposed to moderate wave action in eutrophic areas. Since the absence of an avoidance strategy increases the resistance to low-light stress at the expense of increased drag forces, there is a limit to the wave action that V. natans can withstand. This study indicates that biomechanics could be important when determining the distribution pattern of V. natans in Lake Erhai.
Effects of site-specific climatic conditions on the radial growth of the lichen biomonitor Xanthoria parietina
Abstract
The protocols commonly applied in surveys with lichens as biomonitors of airborne trace elements require analyses of samples derived from thalli or parts of thalli grown in the last year before sampling, under the postulation that samples of the same size are of the same age. Unfortunately, the influence of ecological site-specific factors on lichen growth is still largely ignored, so that samples of the same size collected in environmentally and climatically diverse sites might actually differ in age. This work aims at quantifying the influence of climatic conditions on the radial growth rates (RaGRs) of Xanthoria parietina, one of the most popular lichen biomonitors. RaGR was monitored in seven populations distributed along an altitudinal transect of 30 km in the Classical Karst (NE Italy), from 20 to 500 m above sea level. For c. 17 months, lobe growth was measured seasonally with a digital calliper, and site-specific climatic variables were monitored by means of thermo-hygrometric sensors and implemented by meteorological data. Finally, the lobe growth of X. parietina was modelled as a function of 18 environmental variables. Results revealed that thalli of relatively dry sites had significantly lower seasonal RaGR with respect to moister ones. Considering that cumulative precipitations were equally distributed along the transect, it was concluded that RaGR of X. parietina is affected negatively by high air temperatures and positively by high relative humidity. The importance of RaGR variation in lichen bioaccumulation studies is critically discussed.
FDA Approves Sarecycline for Moderate to Severe Acne
The FDA has approved sarecycline (Seysara, Almirall) for patients aged 9 years and older with inflammatory lesions associated with non-nodular moderate to severe acne vulgaris.
FDA Approvals
Efficient water decontamination using layered double hydroxide beads nanocomposites
Abstract
Ni-Al-CO3-layered double hydroxide (LDH) with Ni:Al ratio (3:1) and their nanocomposites with alginate and chitosan beads were prepared and examined for their efficiency in removal of Cd2+ and Cu2+ ions from wastewater. Different parameters such as contact time, pH value, adsorbent weight, and heavy metal ion concentration on the removal efficiency were examined and reported. The prepared beads were examined using X-ray diffraction (XRD), TEM, SEM, and FTIR. Our results revealed a successful preparation of the LDH in rhombohedral hexognal crystal form and the alginate-LDH-chitosan beads. The optimized batch experiment conditions in ambient room temperature were found to be 2 g/L adsorbent dose, 50 mg/L initial concentration of meal, contact time of 2 h, and pH ~ 5 and 6 for removal of Cu2+ and Cd2+, respectively. The adsorption process was well fitted with Langmuir and Freundlich isotherm models (higher R2), with trivial advantage for Freundlich approach. Kinetic studies showed that the adsorption of both Cd2+ and Cu2+ followed the pseudo-second-order. The current study demonstrated that the Ni-Al-CO3 LDH and their novel alginate-chitosan-based nanocomposite could be further tailored and used as efficient adsorbents for the uptake of heavy metals from wastewater.
Issue Information
Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue S3, Page 1-2, October 2018.
Ultra-high-field arterial spin labelling MRI for non-contrast assessment of cortical lesion perfusion in multiple sclerosis
Abstract
Objectives
To assess the feasibility of using an optimised ultra-high-field high-spatial-resolution low-distortion arterial spin labelling (ASL) MRI acquisition to measure focal haemodynamic pathology in cortical lesions (CLs) in multiple sclerosis (MS).
Methods
Twelve MS patients (eight female, mean age 50 years; range 35–64 years) gave informed consent and were scanned on a 7 Tesla Philips Achieva scanner. Perfusion data were collected at multiple post-labelling delay times using a single-slice flow-sensitive alternating inversion recovery ASL protocol with a balanced steady-state free precession readout scheme. CLs were identified using a high-resolution Phase-Sensitive Inversion Recovery (PSIR) scan. Significant differences in perfusion within CLs compared to immediately surrounding normal appearing grey matter (NAGMlocal) and total cortical normal appearing grey matter (NAGMcortical) were assessed using paired t-tests.
Results
Forty CLs were identified in PSIR scans that overlapped with the ASL acquisition coverage. After excluding lesions due to small size or intravascular contamination, 27 lesions were eligible for analysis. Mean perfusion was 40 ± 25 ml/100 g/min in CLs, 53 ± 12 ml/100 g/min in NAGMlocal, and 53 ± 8 ml/100 g/min in NAGMcortical. CL perfusion was significantly reduced by 23 ± 9% (mean ± SE, p = 0.013) and 26 ± 9% (p = 0.006) relative to NAGMlocal and NAGMcortical perfusion, respectively.
Conclusion
This is the first ASL MRI study quantifying CL perfusion in MS at 7 Tesla, demonstrating that an optimised ASL acquisition is sensitive to focal haemodynamic pathology previously observed using dynamic susceptibility contrast MRI. ASL requires no exogenous contrast agent, making it a more appropriate tool to monitor longitudinal perfusion changes in MS, providing a new window to study lesion development.
Key Points
• Perfusion can be quantified within cortical lesions in multiple sclerosis using an optimised high spatial resolution arterial spin Labelling MRI acquisition at ultra-high-field.
• The majority of cortical lesions assessed using arterial spin labelling are hypo-perfused compared to normal appearing grey matter, in agreement with dynamic susceptibility contrast MRI literature.
• Arterial spin labelling MRI, which does not involve the injection of a contrast agent, is a safe and appropriate technique for repeat scanning of an individual patient.
Meniscal body extrusion and cartilage coverage in middle-aged and elderly without radiographic knee osteoarthritis
Abstract
Objectives
To determine meniscal extrusion and cartilage coverage on magnetic resonance (MR) images and factors associated with these parameters in knees of middle-aged and elderly persons free from radiographic tibiofemoral osteoarthritis (OA).
Methods
Seven hundred eighteen persons, free of radiographic tibiofemoral OA, aged 50–90 years from Framingham, MA, USA, were included. We measured meniscal extrusion on 1.5 T MRI of both knees to evaluate both medial and lateral meniscal body extrusion and cartilage coverage. We also determined meniscal morphology and structural integrity. The multivariable association with age, body mass index (BMI), and ipsilateral meniscal damage was also evaluated.
Results
The mean meniscal body extrusion medially was 2.7 mm and laterally 1.8 mm. The tibial cartilage coverage was about 30% of ipsilateral cartilage surface (both compartments). The presence of ipsilateral meniscal damage was associated with more extrusion in only the medial compartment, 1.0 mm in men and 0.6 mm in women, and less cartilage coverage proportion, -5.5% in men and -4.6% in women.
Conclusions
Mean medial meniscal body extrusion in middle-aged or older persons without radiographic tibiofemoral OA approximates the commonly used cutoff (3 mm) to denote pathological extrusion. Medial meniscal damage is a factor associated with medial meniscal body extrusion and less cartilage coverage.
Key Points
• Medial meniscal extrusion in middle-aged/older persons without OA is around 3 mm.
• Lateral meniscal extrusion in middle-aged/older persons without OA is around 2 mm.
• Meniscal damage is associated with medial meniscal extrusion and less cartilage coverage.
Comparison of radiomics machine-learning classifiers and feature selection for differentiation of sacral chordoma and sacral giant cell tumour based on 3D computed tomography features
Abstract
Objective
We aimed to identify optimal machine-learning methods for preoperative differentiation of sacral chordoma (SC) and sacral giant cell tumour (SGCT) based on 3D non-enhanced computed tomography (CT) and CT-enhanced (CTE) features.
Methods
A total of 95 patients were divided into a training set and a validation set. Three best feature selection methods (Relief, least absolute shrinkage and selection operator (LASSO) and Random Forest (RF)) and three classification methods, including generalised linear models (GLM), support vector machines (SVM) and RF, were compared for their performance in distinguishing SC and SGCT. The performance of the radiomics model was investigated via area under the receiver-operating characteristic curve (AUC) and accuracy (ACC) analysis.
Results
The selection method LASSO + classifier GLM had the highest AUC of 0.984 and ACC of 0.897 in the validating set, followed by Relief + GLM (AUC = 0.909, ACC = 0.862) and LASSO + SVM (AUC = 0.900, ACC = 0.862) based on CTE features. For CT features, RF + GLM had the highest AUC of 0.889, while LASSO + GLM achieved a high ACC of 0.793 in the validating set. Regardless of the methods, CTE features significantly outperformed those from CT for the differentiation of SC and SGCT (ZAUC = -3.029, ZACC = -4.553; p < 0.05).
Conclusions
Our study demonstrated CTE features performed better than CT features. The selection method LASSO + classifier GLM had the best performance in differentiation of SC and SGCT, which could enhance the application of radiomics methods in sacral tumours.
Key Points
• Sacral chordoma and sacral giant cell tumour are the two most common primary tumours of the sacrum with many common clinical and imaging characteristics.
• A radiomics model helps clinicians to identify the histology of a sacral tumour.
• CTE features should be preferred.
Impact of image reconstruction methods on quantitative accuracy and variability of FDG-PET volumetric and textural measures in solid tumors
Abstract
Objective
This study aims to assess the impact of different image reconstruction methods on PET/CT quantitative volumetric and textural parameters and the inter-reconstruction variability of these measurements.
Methods
A total of 25 oncology patients with 65 lesions (between 2017 and 2018) and a phantom with signal-to-background ratios (SBR) of 2 and 4 were included. All images were retrospectively reconstructed using OSEM, PSF only, TOF only, and TOFPSF with 3-, 5-, and 6.4-mm Gaussian filters. The metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were measured. The relative percent error (ΔMTV and ΔTLG) with respect to true values, volume recovery coefficients, and Dice similarity coefficient, as well as inter-reconstruction variabilities were quantified and assessed. In clinical scans, textural features (coefficient of variation, skewness, and kurtosis) were determined.
Results
Among reconstruction methods, mean ΔMTV differed by -163.5 ± 14.1% to 6.3 ± 6.2% at SBR2 and -42.7 ± 36.7% to 8.6 ± 3.1 at SBR4. Dice similarity coefficient significantly increased by increasing SBR from 2 to 4, ranging from 25.7 to 83.4% between reconstruction methods. Mean ΔTLG was -12.0 ± 1.7 for diameters > 17 mm and -17.8 ± 7.8 for diameters ≤ 17 mm at SBR4. It was -31.7 ± 4.3 for diameters > 17 mm and -14.2 ± 5.8 for diameters ≤ 17 mm at SBR2. Textural features were prone to variations by reconstruction methods (p < 0.05).
Conclusions
Inter-reconstruction variability was significantly affected by the target size, SBR, and cut-off threshold value. In small tumors, inter-reconstruction variability was noteworthy, and quantitative parameters were strongly affected. TOFPSF reconstruction with small filter size produced greater improvements in performance and accuracy in quantitative PET/CT imaging.
Key Points
• Quantitative volumetric PET evaluation is critical for the analysis of tumors.
• However, volumetric and textural evaluation is prone to important variations according to different image reconstruction settings.
• TOFPSF reconstruction with small filter size improves quantitative analysis.
Pelvic MRI after induction chemotherapy and before long-course chemoradiation therapy for rectal cancer: What are the imaging findings?
Abstract
Objectives
To determine the appearance of rectal cancer on MRI after oxaliplatin-based chemotherapy (ICT) and make a preliminary assessment of MRI's value in predicting response to total neoadjuvant treatment (TNT).
Methods
In this IRB-approved, HIPAA-compliant, retrospective study between 1 January 2010–20 October 2014, pre- and post-ICT tumour T2 volume, relative T2 signal intensity (rT2SI), node size, signal intensity and border characteristics were assessed in 63 patients (65 tumours) by three readers. The strength of association between the reference standard of histopathological percent tumour response and tumour volume change, rT2SI and lymph node characteristics was assessed with Spearman's correlation coefficient and Wilcoxon's rank sum test. Cox regression was used to assess association between DFS and radiological measures.
Results
Change in T2 volume was not associated with TNT response. Change in rT2SI showed correlation with TNT response for one reader only using selective regions of interest (ROIs) and borderline correlation with response using total volume ROI. There was a significant negative correlation between baseline and post-ICT node size and TNT response (r = -0.25, p = 0.05; r = -0.35, p = 0.005, readers 1 and 2, respectively). Both baseline and post-induction median node sizes were significantly smaller in complete responders (p = 0.03, 0.001; readers 1 and 2, respectively). Change in largest baseline node size and decrease in post-ICT node signal heterogeneity were associated with 100% tumour response (p = 0.04). Nodal sizes at baseline and post-ICT MRI correlated with DFS.
Conclusion
In patients undergoing post-ICT MRI, tumour volume did not correlate with TNT response, but decreased lymph node sizes were significantly associated with complete response to TNT as well as DFS. Relative T2SI showed borderline correlation with TNT response.
Key Points
• MRI-based tumour volume after induction chemotherapy and before chemoradiotherapy did not correlate with overall tumour response at the end of all treatment.
• Lymph node size after induction chemotherapy and before chemoradiotherapy was strongly associated with complete pathological response after all treatment.
• Lymph node sizes at baseline and post-induction chemotherapy MRI correlated with disease-free survival.
Gastric cancer and imaging biomarkers: Part 1 – a critical review of DW-MRI and CE-MDCT findings
Abstract
The current standard of care for gastric cancer imaging includes heterogeneity in image acquisition techniques and qualitative image interpretation. In addition to qualitative assessment, several imaging techniques, including diffusion-weighted magnetic resonance imaging (DW-MRI), contrast-enhanced multidetector computed tomography (CE-MDCT), dynamic-contrast enhanced MRI and 18F-fluorodeoxyglucose positron emission tomography, can allow quantitative analysis. However, so far there is no consensus regarding the application of functional imaging in the management of gastric cancer. The aim of this article is to specifically review two promising biomarkers for gastric cancer with reasonable spatial resolution: the apparent diffusion coefficient (ADC) from DW-MRI and textural features from CE-MDCT. We searched MEDLINE/ PubMed for manuscripts published from inception to 6 February 2018. Initially, we searched for (gastric cancer OR gastric tumour) AND diffusion weighted magnetic resonance imaging. Then, we searched for (gastric cancer OR gastric tumour) AND texture analysis AND computed tomography. We collated the results from the studies related to this query. There is evidence that: (1) the ADC is a promising biomarker for the evaluation of the aggressiveness (T and N stage), treatment response and prognosis of gastric cancer; (2) textural features are related to the degree of differentiation, Lauren classification, treatment response and prognosis of gastric cancer. We conclude that these imaging biomarkers hold promise as effective additional tools in the diagnostic pathway of gastric cancer and may facilitate the multidisciplinary work between the radiologist and clinician, and across different institutions, to provide a greater biological understanding of gastric cancer.
Key Points
• Quantitative imaging is the extraction of quantifiable features from medical images for the assessment of normal or pathological conditions and represents a promising area for gastric cancer.
• Quantitative analysis from CE-MDCT and DW-MRI allows the extrapolation of multiple imaging biomarkers.
• ADC from DW-MRI and CE- MDCT-based texture features are non-invasive, quantitative imaging biomarkers that hold promise in the evaluation of the aggressiveness, treatment response and prognosis of gastric cancer.
Calcinosis cutis facial en una paciente con dermatomiositis paraneoplásica
Publication date: October 2018
Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 8
Author(s): M. Herrero-Moyano, C. Martínez-Mera, C. García-García, E. Dauden
Supresión de un cuadro de micosis fungoide recurrente con distribución zosteriforme mediante tratamiento de mantenimiento con valaciclovir
Publication date: October 2018
Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 8
Author(s): D.J. Lewis, T. Hinojosa, W.H. Chan, J.H. Wu, M. Duvic
Regresión completa espontánea del tumor primario en el carcinoma de células de Merkel
Publication date: October 2018
Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 8
Author(s): J. Marcoval, F. Valentí-Medina, R.M. Penín, J. Bermejo
Alopecia areata y pustulosis palmoplantar: informe de 4 casos
Publication date: October 2018
Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 8
Author(s): T. Hiraiwa, T. Yamamoto
Inflamación de queratosis actínicas durante el tratamiento con panitumumab
Publication date: October 2018
Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 8
Author(s): M.M. Escudero-Góngora, L.J. del Pozo-Hernando, O. Corral-Magaña, E. Antón
Ampollas inducidas por PUVA. Presentación de 5 casos
Publication date: October 2018
Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 8
Author(s): I. Vázquez-Osorio, S. González-Delgado, C. Suárez-García, P. Gonzalvo-Rodríguez, E. Rodríguez-Díaz
Resumen
Las ampollas secundarias al tratamiento con PUVA son un efecto secundario de la fotoquimioterapia poco descrito en la literatura científica. Se caracteriza por la aparición espontánea de ampollas asintomáticas localizadas fundamentalmente en los miembros inferiores, que se resuelven sin necesidad de tratamiento. El diagnóstico diferencial debe plantearse con una reacción fototóxica, con la pseudoporfiria y con el penfigoide ampolloso inducido por PUVA. Presentamos 5 casos de ampollas secundarias a la terapia PUVA, con el objetivo de dar a conocer las características clínicas e histológicas de dicha entidad. Su correcto diagnóstico evitará la interrupción del tratamiento, así como la realización de procedimientos diagnósticos y terapéuticos innecesarios.
Abstract
Blisters associated with PUVA treatments are an adverse effect of photochemotherapy that has been reported in the literature. Asymptomatic blisters appear spontaneously mainly on the lower limbs and resolve without treatment. The differential diagnoses to consider include a phototoxic reaction, pseudoporphyria, and PUVA-induced bullous pemphigoid. We describe the clinical and histologic features in 5 cases of blistering secondary to PUVA treatment. If this adverse effect is accurately diagnosed, photochemotherapy need not be interrupted, and unnecessary diagnostic procedures and additional treatments can be avoided.
Graphical abstract
Ampollas durante la fototerapia
Publication date: October 2018
Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 8
Author(s): D. de Argila
La importancia de medir la afectación psicológica en la psoriasis y Como tratamos a nuestros pacientes pediátricos con psoriasis
Publication date: October 2018
Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 8
Author(s): A. Pérez Ferriols
Eritema anular centrífugo en un paciente con síndrome de Budd-Chiari
Publication date: October 2018
Source: Actas Dermo-Sifiliográficas, Volume 109, Issue 8
Author(s): A.S. Borges, A. Brasileiro, S. Santos, J. Saiote
Versatility of iron-rich steel waste for the removal of high arsenic and sulfate concentrations in water
Abstract
The aim of this work is to evaluate the application of a steel waste, basic oxygen furnace sludge (BOFS), rich in iron, to treat water contaminated with elevated arsenic and sulfate concentrations. In the first step, three doses (10, 60, and 80 g L−1) of BOFS were tested to investigate the removal of As(III) and As(V) (67 mg L−1) and sulfate (3700 mg L−1) separately from an aqueous solution. In the second step, the efficacies of BOFS (10 g L−1) and commercial ZVI (5 g L−1) were compared to simultaneously remove arsenic and sulfate. The pH of the feed solution was adjusted to 2.5 and monitored during the experiment. The use of BOFS achieved arsenic removal up to 92% and sulfate removal of nearly 40% after 72 h of contact time. Use of BOFS also increased the solution pH to 12. Similar removal levels were achieved with both BOFS and ZVI. These results confirm the potential application of BOFS to remove high arsenic and sulfate concentrations from acidic solutions. The data obtained here should be used as a basis for further studies on the remediation of acid mine drainage with high concentrations of arsenic and sulfate using an abundant and low-cost steel waste.
Pesticide residues in Indian raw honeys, an indicator of environmental pollution
Abstract
Honey has multifaceted beneficial properties, but polluted environment and unapproved apicultural practices have led to its contamination. In this study, QuEChERS method followed by chromatographic analysis by GC-μECD/FTD and GC-MS was validated and used for determination of 24 pesticides in 100 raw honey samples from various floral origins of Northern India. Matrix-matched calibrations showed that the method was selective and linear (r2 > 0.99) with detection limit < 9.1 ng g−1 for all the studied pesticides except for monocrotophos (21.3 ng g−1). The average recoveries at different fortification levels ranged from 86.0 to 107.7% with relative standard deviation < 20%. Pesticide residues were detected in 19.0% samples, and most prevalent compounds detected were dichlorvos in 6.0% samples followed by monocrotophos (5.0%), profenofos (5.0%), permethrin (4.0%), ethion (3.0%), and lindane (3.0%) with concentrations ranging from 58.8 to 225.5, from 96.0 to 430.1, from 14.6 to 43.2, from 27.8 to 39.6, from 25.6 to 28.0, and from 19.6 to 99.2 ng g−1, respectively. Honey samples originating from cotton, sunflower, and mustard crops (33.3%) that tested positive for pesticide residues were found to be significantly higher (p < 0.05) than the honey originating from natural and fruity vegetation (13.5%). Therefore, considering the contamination of environmental compartments due to extensive application of pesticides in the study area and their potential for subsequent transfer to honey by the expeditious bees, the results of present study proclaim that honey may be used as an indicator of environmental pollution. Further, estimated daily intakes of all contaminants were found to be at levels well below their acceptable daily intakes suggesting that consumption of honeys at current levels does not pose deleterious effects on human health. However, precautionary measures should always be taken considering the customary honey feeding in infants and cumulative effect of these chemicals in the foreseeable future.
More than keratitis, ichthyosis, and deafness: multisystem effects of lethal GJB2 mutations
Publication date: Available online 2 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Evelyn Lilly, Christopher G. Bunick, Alexander M. Maley, Shali Zhang, Mary K. Spraker, Amy J. Theos, Karina L. Vivar, Lucia Seminario-Vidal, Adam E. Bennett, Robert Sidbury, Yasushi Ogawa, Masashi Akiyama, Barbara Binder, Smail Hadj-Rabia, Raffaella A. Morotti, Earl J. Glusac, Keith A. Choate, Gabriele Richard, Leonard M. Milstone
Abstract
Background
Infant death in KID syndrome is recognized; its association with specific genotypes and pathophysiology is inadequately understood.
Objective
To discover characteristics that account for poor outcomes in lethal KID syndrome.
Methods
We collected four new cases and nine previously reported, genotyped cases of lethal KID syndrome. We performed new molecular modeling of the lethal mutants GJB2 p.A88V and GJB2 p.G45E.
Results
Infant death occurred in all patients with GJB2 p.G45E and p.A88V; it is unusual with other GJB2 mutations. Early death with those two "lethal" mutations is likely multifactorial: during life all had at least one serious infection; most had poor weight gain and severe respiratory difficulties; many had additional anatomic abnormalities. Structural modeling of GJB2 p.G45E identified no impact on the salt bridge previously predicted to account for abnormal central CO2 sensing of GJB2 p.A88V.
Limitations
Clinical review was retrospective.
Conclusion
GJB2 p.G45E and p.A88V are the only KID syndrome mutations associated with uniform early lethality. Those electro-physiologically severe mutations in GJB2 reveal abnormalities in many organs in lethal KID syndrome. All KID syndrome patients may have subtle abnormalities beyond eyes, ears and skin. Early genotyping of KID syndrome births will inform prognostic discussion.
Opioid Prescribing for Acute Postoperative Pain After Cutaneous Surgery
Publication date: Available online 2 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Jonathan J. Lopez, Nafisseh S. Warner, Christopher J. Arpey, Christian L. Baum, Jerry D. Brewer, Clark C. Otley, Halena M. Gazelka, Randall K. Roenigk
Abstract
Background
Little information is available to predict which patients require opioid analgesia following cutaneous surgery. When opioids are indicated, information is lacking regarding the optimal opioid agent selection and dosage.
Objective
To make recommendations for opioid prescription after cutaneous surgery.
Methods
A PubMed literature search was conducted to review the available literature. Recommendations are presented on the basis of available evidence and the opinion of the authors.
Results
Most patients undergoing cutaneous surgery do not require opioid analgesia. For those who do, the pain duration warranting opioid analgesia is generally less than 36 hours. Opioid refill requests warrant a follow-up visit to ascertain the cause of ongoing pain after excisional procedures.
Limitations
The recommendations are not based on prospective randomized trials.
Conclusions
The presented recommendations for opioid prescription practice are derived from available evidence, recommendations, and expert opinion.
Prognostic value of the Breslow/diameter ratio in cutaneous melanoma
Publication date: Available online 2 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Antonio Piñero-Madrona, Alvaro Jesús Goméz-Ruiz, Guadalupe Ruiz-Merino, Enrique Martínez-Barba, Pablo Cerezuela-Fuentes, José Neptuno Rodríguez-López, Juan Cabezas-Herrera
Guideline-Based Medicine Grading based upon the Guidelines of Care for Ambulatory Atopic Dermatitis Treatment in the United States
Publication date: Available online 2 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Alan B. Fleischer
Abstract
Purpose
This study was designed to assess the adherence to evidence-based guideline of care for atopic dermatitis (AD).
Methods
To characterize AD treatment for United States, ambulatory visits from the 2006 to 2015 National Ambulatory Medical Care Survey were analyzed. For each medication prescription, a grade was assigned based upon the American Academy of Dermatology (AAD) treatment guidelines for topical and systemic medications. A composite grade, analogous to the US academic grading system, from A to F, based upon all visit prescriptions was calculated.
Results
Across specialty groups, prescribing differences were noted. Systemic corticosteroids were more likely to be prescribed by family and general physicians (FPGP) and less likely by pediatricians. Dermatologists were more likely than other specialties to prescribe nonsedating antihistamines, which lack a guideline-base supporting their use. Depending upon modeling of care assumptions, all physician specialty visits earned mean guideline-based grades of B or C in their care of AD patients.
Limitations
The clinical, social, and demographic factors influencing prescribing behavior cannot be completely assessed using extant data.
Conclusions
This preliminary study demonstrates that physicians may benefit from reviewing guidelines of care and there may be an educational gap in the implementation of these guidelines.
Association of multiple primary melanomas with malignancy risk: a population-based analysis of the Surveillance, Epidemiology, and End Results Program database from 1973-2014
Publication date: Available online 2 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Emily D. Cai, Susan M. Swetter, Kavita Y. Sarin
Abstract:
Background
Genetic and environmental risk factors have been associated with the development of multiple primary melanomas (MPM). We hypothesized that individuals with MPM may have increased predisposition to developing internal malignancies.
Objective
To identify the risk of subsequent malignancies in MPM patients.
Methods
Multiple primary standardized incidence ratios were analyzed for individuals with ≥1, ≥2 and ≥3 primary melanomas (PM) in the SEER database from 1973-2014.
Results
223,799 individuals with ≥1, 19,709 with ≥2 and 3,995 with ≥3 PM were identified. Risks of subsequent internal malignancy increased with number of PM, with observed to expected (O/E) ratios of 0.99, 1.14, and 1.23 (p<0.05) for patients with at least one, two and three PM respectively. Internal malignancy was higher in younger MPM patients and those with superficial spreading melanoma. The most common malignancies amongst MPM patients include breast, prostate, thyroid, soft tissue, brain, kidney, non-Hodgkin's lymphoma, and chronic lymphocytic leukemia. Risk of subsequent cutaneous melanoma increased with O/E ratios of 8.09, to 22.52, to 41.03 (p<0.05) respectively.
Limitations
SEER records limited information about pigmentation phenotypes, histology, and treatments.
Conclusion
Patients with MPM have increased risk of subsequent internal and cutaneous malignancies and may benefit from tight adherence to age-specific cancer screening.
Trends in utilization of topical medications for treatment of rosacea in the United States (2005-2014) – a cohort analysis
Publication date: Available online 2 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Hadar Lev-Tov, Joanne S. Rill, Guodong Liu, Joslyn S. Kirby
Cost Analysis of a Store and Forward Teledermatology Consult System in Philadelphia
Publication date: Available online 2 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Xiaoshi Yang, John S. Barbieri, Carrie L. Kovarik
Abstract
Background
Store-and-forward (SAF) teledermatology (TD) has the potential to increase access to timely, high-quality care for underserved populations. However, the cost-effectiveness of TD for underserved populations is uncertain.
Objective
This study evaluates the potential cost savings associated with a SAF TD program implemented for an underserved population in the city health clinics of urban Philadelphia.
Methods
We performed a retrospective analysis of SAF TD consultations for 700 outpatients managed in 12 Philadelphia primary care clinics. Primary care providers (PCPs) were asked to specify a treatment plan, as well as the type of care for the patient, in the absence of the TD service. Analysis compared cost of each patient case using the TD consult model versus conventional care.
Results
Twenty-seven percent (189/700) of in-person dermatology clinic visits and 3.29% (23/700) of emergency room (ER) visits were avoided using TD. Compared to conventional care, mean expected cost savings were $10.00-$52.65 per TD consult. In sensitivity analyses, these estimated savings remained positive across a range of parameters.
Limitations
The cost analysis relies on several assumptions regarding the cost of care, and indirect costs were not included.
Conclusion
Teledermatology can be a cost saving model while increasing access to dermatologic care.
Infertility and Teratogenicity after Paternal Exposure to Systemic Dermatologic Medications: A Systematic Review
Publication date: Available online 2 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): George A. Zakhem, Catherine C. Motosko, Euphemia W. Mu, Roger S. Ho
Abstract
Background
This systematic review assesses effects of paternal exposure of dermatologic medications, using the former US Food and Drug Administration (FDA) pregnancy categories as a benchmark.
Objective
To assess whether systemic dermatologic medications can cause infertility and teratogenicity when taken by men.
Methods
Category D and X dermatologic medications were identified; a systematic review of the literature and reviews of the FDA Adverse Events Reporting System (FAERS) and prescribing information were performed to identify effects on male fertility and teratogenicity. Secondary search was performed to assess for other systemic dermatologic medications causing teratogenicity or infertility following paternal exposure.
Results
Thirteen medications met inclusion criteria. Nineteen of 1,032 studies were included after systematic review of the literature. Studies evaluating medication effects with paternal exposure were identified for 10 of 13 evaluated medications, and evidence of a negative effect was identified for 6 medications.
Limitations
We did not encounter any studies for 3 medications that met inclusion criteria. Information submitted to the FAERS may not reflect incidence of side effects.
Conclusions
Many former pregnancy category D and X systemic dermatologic medications also have effects on male fertility. More research and better-quality studies are required in this area, particularly assessing potential teratogenicity.
"Treatment of male pattern alopecia with platelet-rich plasma: a double blind controlled study with analysis of platelet number and growth factor levels"
Publication date: Available online 2 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Bruno L. Rodrigues, Silmara AL. Montalvão, Rebeca BB. Cancela, Francesca AR. Silva, Aline Urban, Stephany C. Huber, José Luiz RC Júnior, José Fábio SD. Lana, Joyce M. Annichinno-Bizzacchi
ABSTRACT
Background
Promising results were described with platelet-rich plasma (PRP) in androgenetic alopecia that could be associated to platelet number and growth factor levels.
Objective
Analyze the platelet number and growth factor levels in PRP and its correlation with hair growth parameters evaluated by TrichoScan.
Methods
Twenty-six patients randomized to receive four subcutaneous injections of PRP or saline. Hair growth, hair density, and percentage of anagen hairs were evaluated before, after and three months after the last injection using TrichoScan method. Growth factors (PDGF, EGF and VEGF) were measured by Luminex method.
Results
We demonstrated a significant increase in hair count (p = 0.0016), hair density (p = 0.012) and percentage of anagen hairs (p = 0.007) in PRP group when compared to control group, without correlation with platelet counts or quantification of the growth factors in PRP.
Conclusion
Our data favors the use of PRP as therapeutic alternative in the treatment of androgenetic alopecia. The lack of association between platelet count, PDGF, EGF and VEGF levels and clinical improvement suggest that other mechanisms could be involved in this response.
Limitations
Other growth factors that could be related with PRP response were not evaluated
Beyond JAAD January 2019
Publication date: Available online 1 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Andrew Bronin, Robert Phelps, Robert Sidbury
Lower Socioeconomic Status is Associated with Delayed Access to Care for Infantile Hemangioma, a Cohort Study
Publication date: Available online 1 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Erina Lie, Kevin J. Psoter, Katherine B. Püttgen
ABSTRACT
Background
Early specialist evaluation during rapid proliferative growth of complicated infantile hemangiomas (IH) is crucial. Health disparities and barriers of access-to-care for children with IH have not been examined.
Objective
Investigate whether socioeconomic status (SES) is associated with age at subspecialist presentation for IH evaluation.
Method
Retrospective cohort study of 804 children presenting to a large academic hospital. Primary outcome was age at initial presentation. Covariates included demographic, socioeconomic, geographic, and clinical characteristics. Medicaid or Children's Health Insurance Program (CHIP) were proxies for lower SES. Analysis of covariance, χ2 tests, and generalized ordered logistic regressions were performed.
Results
Children with lower SES had higher odds of presenting after 3 months of age (OR 2.11, 95% CI 1.31-3.38). In the subset that qualified for institutional care management program (ICMP), no risk factors were associated with delayed presentation.
Limitations
Use of insurance and economic distress as proxies for SES; exclusion of uninsured children may underestimate racioethnic effects; single academic center study limiting generalizability.
Conclusions
Children with IH and lower SES were more likely to present later to specialists, but those enrolled in an ICMP did not, suggesting that integrated ICMPs may mitigate disparities and delayed access-to-care for IH among lower SES populations.
Gabor-Domain Optical Coherence Tomography to Aid in Mohs Resection of Basal Cell Carcinoma
Publication date: Available online 1 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Patrice Tankam, Jonathan Soh, Cristina Canavesi, Mara Lanis, Adam Hayes, Andrea Cogliati, Jannick P. Rolland, Sherrif F. Ibrahim
Evaluating the cost-effectiveness of teldermatology
Publication date: Available online 1 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): John S. Barbieri, Xiaoshi Yang, Carrie L. Kovarik
Association between atopic dermatitis and autoimmune disorders in US adults and children: A cross-sectional study
Publication date: Available online 1 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Shanthi Narla, Jonathan I. Silverberg
Abstract
Background
Little is known about the risk and predictors of autoimmune diseases in children and adults.
Objective
To determine the prevalence, predictors and excess costs of autoimmune disease in AD patients.
Methods
Cross-sectional study of the 2002–2012 National Inpatient Sample, including a ∼20% sample of all US hospitalizations (n=87,053,155 adults and children).
Results
The prevalence [95% confidence interval {CI95}] of autoimmune disease was higher in adults (7.9% [7.3-8.5%] vs. 5.7 [5.7-5.8%]) and children (2.0% [1.7-2.3%] vs. 1.0% [0.9-1.1%]) with vs. without AD. In multivariable logistic regression models controlling for socio-demographics, adult (adjusted odds ratio [CI95]: 1.45 [1.32-1.8]) and pediatric (2.08 [1.73-2.50]) AD were associated with any autoimmune disorder. In particular, AD was associated with 18 of 32 autoimmune disorders examined in adults and 12 of 24 examined in children, including disorders of the skin, endocrine, gastrointestinal, hematologic and musculoskeletal systems. AD patients hospitalized with any autoimmune disorder had higher cost of inpatient care with $2.5-$50 million excess annual costs.
Conclusions
Adults and children with AD had increased cutaneous and extra-cutaneous autoimmune disorders, which were associated with a considerable cost-burden.
A systematic review and meta-analysis of the regional and age-related differences of atopic dermatitis clinical characteristics
Publication date: Available online 1 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Yik Weng Yew, Jacob P. Thyssen, Jonathan I. Silverberg
Abstract
Background
Previous studies found conflicting results about the commonality of different atopic dermatitis (AD) signs and symptoms.
Objective
To determine the prevalences of AD characteristics and differences by region and age.
Methods
A systematic review was performed of all published studies in MEDLINE, EMBASE, SCOPUS, LILACS, Cochrane, China National Knowledge Infrastructure, Taiwan electronic periodical services and CiNii that analyzed the proportion of AD characteristics. Two reviewers performed study title/abstract review and data abstraction.
Results
One hundred and one studies reported proportion of AD features with sufficient data for meta-analysis. The most prevalent AD features were pruritus, lichenification and xerosis. There were differences of AD characteristics by study region. Flexural involvement was less commonly reported in India, America and Iran. East Asian studies reported more erythroderma, truncal, extensor, scalp and auricular involvement. Southeast Asian studies reported more exudative eczema, truncal involvement, lichenification and prurigo nodules. Studies from Iran reported more head, face and neck involvement, pityriasis alba, and xerosis. Studies from Africa reported more papular lichenoid lesions, palmar hyperlinearity, ichthyosis and orbital darkening.
Limitations
Heterogeneity between studies and limited reporting of certain AD clinical characteristics.
Conclusions
AD characteristics are heterogeneous and vary by region and age.
Bullae for You: The Increasing Importance and Implications of Drug-induced Bullous Pemphigoid
Publication date: Available online 1 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Warren R. Heymann
The role of TERT promoter mutations in differentiating recurrent nevi from recurrent melanomas: a retrospective, case-control study
Publication date: Available online 1 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Kara E. Walton, Erin M. Garfield, Bin Zhang, Victor L. Quan, Katherine Shi, Lauren S. Mohan, Alexandra M. Haugh, Timothy VandenBoom, Pedram Yazdan, Maria Cristina Isales, Elnaz Panah, Pedram Gerami
Abstract
Background
Repigmentation at previous biopsy sites pose a significant diagnostic dilemma given clinical and histologic similarities between recurrent nevi and locally recurrent melanoma. While common in melanoma, the role of TERT promoter mutations (TPMs) in recurrent nevi is unknown.
Objective
We investigated the role of TPMs in recurrent nevi and whether the presence of hotspot TPM distinguishes recurrent nevi from locally recurrent melanoma. We also characterized clinical and histologic features differentiating these lesions.
Methods
We analyzed 11 locally recurrent melanomas, 17 recurrent nevi, and melanoma and nevus controls to determine TPM status. We also assessed clinical and histologic features of the recurrent groups.
Results
Hotspot TPMs were more common in recurrent melanomas compared to recurrent nevi (p=0.008). Recurrent melanomas were more likely to have solar elastosis (p=0.0047), multi-layering of melanocytes in the epidermis (p=0.0221), adnexal involvement (p=0.0069), and epidermal consumption (p=0.0204). Recurrent nevi had intra-epidermal atypia limited to the area above the scar (p<0.0001) and occurred earlier after the original biopsy (p<0.0008). Solar elastosis, months to recurrence, and hotspot TPM were independently associated with recurrent melanoma in multivariate analysis.
Limitations
This was a retrospective study.
Conclusion
Hotspot TPMs are significantly more frequent in recurrent melanomas and may serve as a diagnostic clue in histologically ambiguous cases.
Acne Disparities in Native Americans
Publication date: Available online 1 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Shannon W. Zullo, Melody Maarouf, Vivian Y. Shi
Correction
Publication date: Available online 1 October 2018
Source: Journal of the American Academy of Dermatology
Author(s):
Trends in the Incidence and Survival of Eccrine Malignancies in the United States: A SEER Population-Based Study
Publication date: Available online 1 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Raghav Tripathi, Harib H. Ezaldein, Jeffrey F. Scott, Jeremy S. Bordeaux
An empirical model for the evaluation of the dissolution rate from a DNAPL - contaminated area
Abstract
This paper investigates dynamic variation in the morphologic distribution of dense non-aqueous phase liquids (DNAPLs), which take into account the coupled mass transfer. Experiments were carried out in a 2D tank representing a reconstructed aquifer model. DNAPL dissolution rates were investigated over a wide range of DNAPL saturations, several source configurations, and different hydraulic conditions. Morphometric indexes are presented that take into consideration further factors affecting the dissolution process. Local information regarding transport parameters related to the characteristics of the medium was obtained through a neural network and an optimization algorithm applied to experimental tracer tests. The history of DNAPL source architecture, in terms of saturation, indentation grade, and orientation, was determined by image analysis. Dissolved concentrations were registered and mass transfer rate coefficients were obtained for a wide range of source-zone configurations. A statistical analysis was performed to develop a constitutive equation that is descriptive of the mass transfer rate as a function of source-zone metric characteristics. A new empirical dissolution model using the proposed morphometric parameters is presented and compared with other models. The mass transfer correlation reported incorporates morphometric parameters and considers the complex and variable architecture of non-miscible contaminants. The proposed correlation can be used for an initial assessment of non-aqueous phase liquid (NAPL) dissolution rates over a wide range of saturation (residual and non-residual) conditions and different aqueous phase velocities within the NAPL source zone.
Performance of full-scale coagulation-flocculation/DAF as a pre-treatment technology for biodegradability enhancement of high strength wastepaper-recycling wastewater
Abstract
Paper mill wastewater leads to a serious damage on the environment owing to the high content of organic matters, suspended solids, toxic substances, and lignin. Hence, exploring new treatment technologies is the passion of environmental engineers to minimize the effluent impact on the environment and cleaner production aspects. This research focused on the performance of full-scale coagulation-fluctuation/DAF system for pre-treatment of high strength wastepaper-recycling wastewater and its effect on biodegradability improvement. To optimize unit performance, optimum coagulant and flocculant doses were firstly determined by jar test without prior change and adjustment of pH in lab-scale experiments. The optimum dosages were obtained by 1500 mg L−1 polyaluminum chloride (PACl) as coagulant coupled with 40 mg L−1 cationic polyacrylamide (C-PAM) as flocculant. Percentage removals of 39 ± 10, 6.8 ± 3.6, 31.0 ± 6.7, 24.0 ± 3.8, and 33.0 ± 20.0 were achieved for COD, sCOD, BOD5, sBOD5, and color, respectively. The average BOD5 to COD ratio after pre-treatment increased from 0.44 to 0.5, whereas the ratio of sBOD5/sCOD dropped from 0.65 to 0.53. A superior effectiveness in reduction of TSS (98.1%) and VSS (98.4%) was also achieved. The results show that the application process is able to prevent malfunction operation in the following bioreactors which is obtainable through bio-treatability enhancement of pre-treated wastewater and reducing the risks of clogging and sludge washout. Attached growth processes are suggested to be applied in the further anaerobic/aerobic processes because of high proportion of soluble fraction of COD in the effluent to avoid poor floc formation and dispersed growth problems.
Multiple cellular neurothekeomas in a middle‐aged woman including the lower extremity: A case report and review of the current literature
Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.
A neurofibroma‐like tumor in a giant congenital nevus
JDDG: Journal der Deutschen Dermatologischen Gesellschaft, EarlyView.
Plaques and tumors in a patient with refractory Sézary syndrome treated with mogamulizumab
JDDG: Journal der Deutschen Dermatologischen Gesellschaft, EarlyView.
Pressure injury prevention and management practices among nurses: A realist case study
International Wound Journal, EarlyView.
A PAX3/BRN2 rheostat controls the dynamics of BRAF mediated MITF regulation in MITFhigh/AXLlow melanoma
Pigment Cell &Melanoma Research, Volume 0, Issue ja, -Not available-.
Real‐world database examining the association between hydroxychloroquine and retinopathy in Taiwan
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
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Publication date: Available online 28 September 2017 Source: Actas Dermo-Sifiliográficas Author(s): F.J. Navarro-Triviño
