Introduction: Morgellons disease is a rare, unexplained skin disorder that whose specific etiology remains a mystery to both the Dermatologic and Psychiatric community as the specific etiology remains unknown. The condition is characterized by the physical presentation of painful sores with reported crawling sensations within the skin and the fixed belief of infection or parasitic infestation. The pathognomonic feature of this disease is the presence of filaments or fibers embedded in and emerging from these sores.
Τρίτη 14 Αυγούστου 2018
Morgellons disease: A review of a mysterious psychodermatologic disorder
Effectiveness of the Eczema Action Plan (EAP) in improving the Eczema Area and Severity Index (EASI) scores among pediatric patients with atopic dermatitis: A pragmatic randomized controlled trial
Introduction: Atopic dermatitis (AD) is a chronically relapsing skin disease that occurs most commonly during early infancy and childhood. Education about the condition is vital in helping patients and their caregivers understand the nature of the disease. Evidence show that adherence is poor. There are no reported studies on interventions done so far to increase treatment adherence among patients with atopic dermatitis in the local setting. This study aims to improve treatment adherence among patients with atopic dermatitis through improvement of the EASI scores.
Mania induced by narrowband ultraviolet B phototherapy treatment
Phototherapy has been used for decades in the treatment of many common dermatologic conditions, such as psoriasis, atopic dermatitis, cutaneous T-cell lymphoma, vitiligo, and scleroderma, among others. Before the commencement of phototherapy, many factors must be considered. For dermatologists, the most important factors include the determination of a patient's skin phototype, concurrent use of photosensitizing agents, and calculation of minimal erythema dose (MED). Though infrequent, the side-effects to phototherapy commonly discussed with patients include burns, ocular toxicity, polymorphous light eruption, potential for skin carcinogenesis, and possible worsening of the skin disease.
Photocarcinogenic risks of narrowband ultraviolet B therapy and psoralen + ultraviolet A therapy
Introduction: Narrowband UVB Therapy and Psoralen + UVA therapy are widely used in the treatment of several skin disorders. Although short-term security has been demonstrated, there are several concerns about long term security and, in particular, the risk of skin cancer after NB-UVB and PUVA therapy.
Hemorrhagic vesiculobullous erythema migrans: An atypical presentation of Lyme disease
Background: Erythema migrans (EM) is the most well known cutaneous manifestation of Lyme disease. Review of the literature and the case described below suggest that atypical cutaneous presentations, such as vesiculobullous EM, can occur and must remain in the differential diagnosis in the proper clinical setting.
Nevus simplex on the midline of the forehead
Background: Recently, studies reported medial frontofacial capillary malformation (CM) that appeared like nevus simplex (NS), but differed in that the lesion had a wider median topography and darker color, and faded more slowly or incompletely.
Insight into trombiculosis: Two case reports
Trombiculosis (also known as "tlazahuate" in Mexico) is an infestation of the skin by the larval stage of various species of mites (chiggers) belonging to the phylum Arthropoda, class Arachnida, subclass Acari, family Trombiculidae. Humans act as accidental hosts. Painless papules similar to molluscoid lesions caused by a hypersensitivity reaction to the mite's saliva can be found. We report the case of a 65-year-old woman and an 86-year-old man from Tizapan el Alto, Jalisco, who worked as farmers.
Evaluation in real life of an adapted information impact for effective photoprotection: An example with patients with actinic keratosis
Introduction: Cutaneous actinic keratosis lesions preferentially affect people with clear skin and indicate an excess of solar exposure. Actinic keratosis can be esthetically troublesome and require a medical care with consultations at regular intervals to allow the dermatologist the detection of a possible development toward a skin cancer. Whatever the treatment chosen by the dermatologist, the medical care is always the opportunity to inform and educate people about the necessity of an effective photoprotection to avoid the risk of recurrence.
Demographic and health care service utilization by 4,417 patients with hidradenitis suppurativa
Background: Data on the health care utilization of hidradenitis suppurativa (HS) patients in primary care settings are scarce.
Primary signet ring cell/histiocytoid carcinoma of the eyelid
Background: Primary cutaneous signet ring cell/histiocytoid carcinoma is a rare, aggressive tumor that occurs most frequently on the eyelid.
Out of the blue and into the black
Introduction: ANCA-associated vasculitides (AAV) are systemic vasculitides involving small to medium vessels and are divided into three separate clinical entities with many overlapping and some distinctive features. Here we present a case having features of all three AAV, including microscopic polyangiitis, granulomatosis with polyangiitis, and eosinophilic granulomatosis with polyangiitis.
Levocarnitine for vismodegib-associated muscle spasms: A pilot randomized, double-blind, placebo-controlled, investigator-initiated trial
Background: Smoothened inhibitors (SIs) are a new targeted therapy approved by the United States Food and Drug Administration (FDA) for the treatment of advanced basal cell carcinoma (BCC). However, no placebo-controlled studies exist on management of their most common side-effect, muscle spasms, which affect up to 80% of patients taking SIs and are the most common reason for drug discontinuation despite tumor response. Based on anecdotal observations of exercise exacerbating SI-associated spasms, and existing evidence that levocarnitine (LC) can reduce markers of exercise induced stress, we explored the effect of oral LC usage on muscle spasms occurring after initiation of vismodegib, an SI.
Impact of surfactant-phase chemistry on skin mildness: Lamellar surfactants provide significant mildness benefits compared with conventional micellar surfactants
Background: Surfactants make up the dominant components in most skin cleansing formulas and are key determinants of a product's performance. It is well known that these surfactants can compromise the stratum barrier function and skin hydration, largely due to surfactant penetration into deeper layers of the stratum corneum and causing disruption of stratum corneum lipids and proteins. It is important to minimize surfactant-induced skin surface damage by developing advanced skin cleansing technologies with improved skin mildness and reduced surfactant penetration into the stratum corneum.
From relative to absolute treatment outcomes—Correlation of PASI 90 and PASI ≤2 in three clinical trials with secukinumab
Introduction: Relative improvement of psoriasis area and severity index (PASI) during treatment compared with baseline PASI is the current standard definition of response in trials and practice. A ≥75% improvement in PASI (PASI 75) is the current treatment goal in international guidelines. With the advent of more effective biologic treatments, an improvement by ≥90% (PASI 90) is under consideration as a new treatment goal. As an alternative for long-term management, baseline-independent absolute PASI treatment goals are being discussed.
Elephantiasic pretibial myxedema, chronic and recalcitrant thyroid dermopathy
Patients afflicted with autoimmune thyroiditis, specifically Graves disease, can have extrathyroidal manifestations such as exophthalmos, thyroid dermopathy, and acropachy. Thyroid dermopathy usually presents as pretibial myxedema (PTM) due to its predilection for the pretibial area. In severe forms of PTM, it can present as the elephantiasic form, which is notoriously resistant to conventional treatment. Due to the disease rarity, only a few case reports of elephantiasic PTM exist in the literature.
Correlation of d-dimers to response to treatment in chronic spontaneous urticaria (UAS7 score): Results from the SUNRISE study
Objectives: Increased levels of blood d-dimers (D-D), the by-products of fibrin degradation, are linked to the severity of chronic spontaneous urticaria (CSU) and to poor response to antihistamines H1 (AH1). Omalizumab (OMA) is a human monoclonal anti–immunoglobulin E antibody registered as an add-on treatment of CSU in adults and adolescents (≥12 years old) with insufficient response to AH1. The SUNRISE study assessed the efficacy of Omalizumab on CSU symptoms and the correlation between D-D levels and response over time to treatment with OMA to explore its potential predictive value.
Cutaneous lymphangitic carcinomatosis associated with parotid gland duct carcinoma: An unreported case
Introduction: Salivary duct carcinoma of parotid gland is an uncommon neoplasm exceptionally associated with cutaneous metastasis. We described an unreported association of cutaneous lymphangitic carcinomatosis from parotid gland duct carcinoma in a 67-year-old woman.
Clinical characteristics and outcomes of patients with superficial venous thrombosis at multiple sites simultaneously
Background: Superficial venous thrombosis (SVT) results from thrombus formation within a superficial vein that is associated with inflammation of the surrounding tissue, and classically presents with pain, tenderness, induration, and/or erythema in the form of a palpable cord. Although traditionally considered a local, benign disorder, recent studies demonstrate that patients with SVT are at significant risk for deep vein thrombosis (DVT), pulmonary embolism (PE), and other venous thromboembolic (VTE) events.
Porokeratosis ptychotropica: A differential diagnosis for “psoriasis” of the gluteal region
A 51-year-old man presented with an 8-year history of a well demarcated erythematous scaly plaque on the buttocks, extending into the natal cleft. Initial skin biopsy was reported as showing features of psoriasis. Treatment with topical calcipotriol, acitretin, UVB and intralesional triamcinolone were ineffective. Repeat biopsies taken from two different areas showed neutrophilic collections within the stratum corneum and a psoriasiform pattern of hyperplasia supporting the initial diagnosis of psoriasis.
Evaluation of the disintegration of linen fabric under composting conditions
Abstract
In recent years, about 10% of the total wastes generated around the world were fabric wastes and, due to the large volume of these wastes, should be well managed. Among the various types of fabrics, some have greater biodegradability and can be decomposed at the acceptable rates under controlled conditions. In this study, the disintegration of linen fabric was investigated under composting conditions. During the composting process, temperature, moisture, and aeration were controlled. According to FTIR spectra of linen fabrics during the composting process, the disintegration of linen fibers was identified as the breakdown of carbonyl groups and hydrogen bonds of cellulosic chains. Regarding the SEM images of linen fabrics, the composting process in the first 45 days led to the breakdown of the fibers, and in the second 45 days of the process, most of the fibers were degraded. Since in the second 45 days of the process, the compost pile temperature is always between 39 and 44 °C and 65–70 °C, it can be concluded that the rate of microbial disintegration of the linen fabric is higher at these temperatures. At the end of the test, the disintegration value of the linen fabric was 55% and the weight loss due to organic matter conversion was 61%. The samples weight loss showed that linen fabric has high biodegradability under composting conditions. The germination index (GI) of the resulting compost was 73.88%, which indicates the produced compost is mature.
Microplastics in Talitrus saltator (Crustacea, Amphipoda): new evidence of ingestion from natural contexts
Abstract
Using Fourier transform infrared spectroscopy (FT-IR) measurements and comparing the spectrum peaks (range 4000–600 cm−1) with reference spectra database and instrument libraries, we observed new evidence of the ingestion of microplastic particles analyzing the digestive tracts of Talitrus saltator. Specimens, sampled in central Italy, probably ingested the particles with natural detritus. Since worldwide many species of invertebrates and vertebrates (e.g., birds) feed on Amphipoda along coastal ecosystems, we hypothesized that microplastic in these crustaceans can be accumulated along the food chain.
Is the informal economic activity a determinant of environmental quality?
Abstract
This study aims to investigate whether the size of the informal economic activity is a determinant of the environmental quality in the case of Turkey. First, the MIMIC model approach will be used to estimate the size of the informal economic activity. Second, time series analysis will be conducted for the period from 1970 to 2014, in order to examine the effect of the size of the informal economic activity on the environmental quality by conducting Carrion-i-Silvestre et al. (Economet Theor 25:1754, 2009) unit root tests, Bound test and Maki (Econ Model 29:2011–2015, 2012) cointegration tests that allow structural breaks will be employed prior to the DOLS, FMOLS, and ARDL approaches for long-run and short-run models. The results suggest that informal economic activity is a positively significant determinant on the environmental quality. Moreover, this paper suggests that both formal and informal economies have significant impact on environmental quality. However, formal economy exerts positively higher effects on the environmental quality compared to informal economy. Turkish authorities need to pay more attention on both formal and informal economic activities to prevent environmental degradation in Turkey.
Effects of microplastics on trophic parameters, abundance and metabolic activities of seawater and fish gut bacteria in mesocosm conditions
Abstract
Plastic pollution is an emerging threat with severe implications on animals' and environmental health. Nevertheless, interactions of plastic particles with both microbial structure and metabolism are a new research challenge that needs to be elucidated yet. To improve knowledge on the effects played by microplastics on free-living and fish gut-associated microbial community in aquatic environments, a 90-day study was performed in three replicated mesocosms (control-CTRL, native polyvinyl chloride-MPV and weathered polyvinyl chloride-MPI), where sea bass specimens were hosted. In CTRL mesocosm, fish was fed with no-plastic-added food, whilst in MPV and MPI food was supplemented with native or exposed to polluted waters polyvinylchloride pellets, respectively. Particulate organic carbon (POC) and nitrogen, total and culturable bacteria, extracellular enzymatic activities, and microbial community substrate utilization profiles were analyzed. POC values were lower in MPI than MPV and CRTL mesocosms. Microplastics did not affect severely bacterial metabolism, although enzymatic activities decreased and microbes utilized a lower number of carbon substrates in MPI than MPV and CTRL. No shifts in the bacterial community composition of fish gut microflora were observed by denaturing gradient gel electrophoresis fingerprinting analysis.
Eliminating redundant spatial variation to better understand the variance of interest of soil potentially toxic elements at different sampling scales in different soil types south of Nanjing, China
Abstract
Sampling scale and prediction of spatial distribution are essential in surveys of soil metal pollution. Sufficient sampling density encompassing the principal spatial sources of variance and prediction of polluted areas with the help of soil maps makes pollution evaluation more reliable and subsequent soil remediation assessment more efficient. Two soil sampling schemes, using 232 points at 2-km intervals in 2002 for sampling at county scale and 109 points at 200–1000-m intervals in 2012 at town scale, were used to study the potentially toxic metals Cu, Cd, Cr, Hg, Ni, Pb, Zn, and the metalloid As in an urban-rural hinge area. We focused on finding characteristics of the explanatory power of soil type toward different sampling scales from 200 to 2000 m, a routine sampling scale in practice for remediation of soil potentially toxic elements (PTEs). We also attempted to eliminate the redundant spatial variation to better understand the variance of soil PTEs. Spatial variation of PTEs at different scales was compared and estimated using soil map units based on geostatistical methods. The explanatory power of the soil map units selected at different scales was significantly different at P < 0.01 and the smaller scales better explained the spatial variance. Anthropic activities profoundly affected the contents of PTEs in soils and the amounts of anthropogenic pollutants released often exceed the contribution from natural sources. Variances of interest of Cr and Cu were underestimated by 72.4 and 32.8%, respectively, due to soil type as a factor but were overestimated for other elements by percentages following the sequence Zn (45.4%) > Hg (28.6%) > Pb (28.8%) > Ni (26.73%) > As (13.7%) > Cd (10.5%). Eliminating variances of zero interest would be helpful in increasing the effectiveness of remediation of metal-contaminated soils.
Cd and Pb accumulation characteristics of phytostabilizer Athyrium wardii (Hook.) grown in soils contaminated with Cd and Pb
Abstract
Interactions between heavy metals in soil could affect soil heavy metal availability and plant uptake. Thus, in this study, Cd and Pb accumulation as well as plant growth of the mining ecotype (ME) and non-mining ecotype (NME) of Athyrium wardii (Hook.) in response to the exposure of Cd and Pb was investigated by a pot experiment. Although the exposure of Cd in combination with Pb further inhibited the growth of the two ecotypes in comparison with the exposure of single Cd or Pb, the ME presented lower biomass decline for the whole plant (22.0%–70.0%) than the NME among most treatments. The presence of Pb promoted Cd accumulation both in above-ground and under-ground parts of the ME. Cd concentrations in under-ground parts of the ME decreased when exposed to higher concentrations of Pb (> 600 mg kg−1). Meanwhile, the presence of Cd inhibited Pb accumulation in above-ground parts of the ME and promoted Pb accumulation in under-ground parts of the ME. Pb concentrations in under-ground parts of the ME decreased when soil Cd concentrations were more than 25 mg kg−1. The partial correlation analysis further demonstrated that the interactions between Cd and Pb stimulated Cd accumulation both in above-ground and under-ground parts of the ME and Pb accumulation in under-ground parts of the ME, while inhibited Pb accumulation in above-ground parts of the ME, showing great benefit for Pb phytostabilization by the ME. Among treatments, the bioaccumulation coefficients for Cd and Pb of the ME, varying from 2.71–31.05 and 20.09–78.06, were much higher than those of the NME. The translocation factors for Cd and Pb of the ME, varying from 0.26–0.52 and 0.01–0.10, were lower than those of the NME. These results indicate that the ME presented greater potential for the phytostabilization of soil contamination with Cd and Pb, especially for Pb.
Facile and environmental benign in situ synthesis of silver nanoparticles for multifunctionalization of wool fibers
Abstract
In this manuscript, we report the simple method to multifunctional wool fiber surfaces. The multifunctional wool fibers were devised with brilliant coloration, antimicrobial activity, and UV-protection property. These multifunctional properties were progressed by in situ assemble of silver nanoparticles (Ag NPs) into the wool fiber surface using green cleaner one-pot route. The proteins existing in the wool fibers acted being a redox active bio-template, facilitating the reduction of Ag+ to Ag0, with simultaneous binding of the produced Ag NPs both on the surface and within the center of the wool fibers. The entire results showed that the Ag NP in situ-incorporated wool fibers can be used as colorant wool fibers effectively, and these colored fibers also exhibit an improvement for multi-functionality properties.
Vermicompost addition influences symbiotic fungi communities associated with leek cultivated in metal-rich soils
Abstract
In the context of urban agriculture, where soils are frequently contaminated with metal(loid)s (TM), we studied the influence of vermicompost amendments on symbiotic fungal communities associated with plants grown in two metal-rich soils. Leek (Allium porrum L.) plants were grown with or without vermicompost in two metal-rich soils characterized by either geogenic or anthropogenic TM sources, to assess the influence of pollutant origin on soil-plant transfer. Fungal communities associated with the leek roots were identified by high throughput Illumina MiSeq and TM contents were measured using mass spectrometry. Vermicompost addition led to a dramatic change in the fungal community with a loss of diversity in the two tested soils. This effect could partially explain the changes in metal transfer at the soil-AMF-plant interface. Our results suggest being careful while using composts when growing edibles in contaminated soils. More generally, this study highlights the need for further research in the field of fungal communities to refine practical recommendations to gardeners.
Graphical abstract
Mapping, in vivo, the uniformity of two skin properties alongside the human face by a 3D virtual approach
International Journal of Cosmetic Science, Volume 0, Issue ja, -Not available-.
Aggression and its association with suicidality in migraine patients: a case-control study
To identify aggression and its association with suicidality in migraine patients.
Latest clinical recommendations on valproate use for migraine prophylaxis in women of childbearing age: overview from European Medicines Agency and European Headache Federation
Migraine is a common and burdensome neurological condition which affects mainly female patients during their childbearing years. Valproate has been widely used for the prophylaxis of migraine attacks and is al...
Fremanezumab blocks CGRP induced dilatation in human cerebral, middle meningeal and abdominal arteries
Fremanezumab (TEV-48125) is a fully humanized anti-calcitonin gene-related peptide (CGRP) monoclonal antibody (mAb) that has shown positive results in the prevention of episodic migraine and chronic migraine. ...
Diagnosis and ecotoxicological risk assessment of 49 elements in sludge from wastewater treatment plants of Chongqing and Xiamen cities, China
Abstract
Limited information about the sludge quality is a major constraint for its usage and proper disposal. This study investigated the occurrence of 49 elements in sludge from 11 wastewater treatment plants (WWTPs) in Chongqing and Xiamen cities of China. The concentration of 46-detected elements ranged from 16.2 μg kg−1 (Pt) to 55.0 g kg−1 (Al) on dry solid basis in the sludge. The enrichment factor of most of the elements was > 1.5, indicating their possible anthropogenic origin. The precious metals had considerably higher enrichment factor ranging from 56.3 to 200,000. Principal component analysis clustered the samples from Chongqing and Xiamen separately to suggest strong spatial variations. Contamination factor, pollution loading index, and integrated pollution degree were calculated to evaluate the elemental pollution risk. The pollution loading index indicated unpolluted to highly polluted levels of the elements in the sludge. In addition, results from the ecotoxicological risk index showed an individual low to very high ecotoxicological risk posed by eight metal(loid)s (As, Cd, Cr, Cu, Mn, Ni, Pb, and Zn) in the WWTPs.
Environmental photochemical fate and UVC degradation of sodium levothyroxine in aqueous medium
Abstract
The synthetic hormone sodium levothyroxine (LTX) is one of the most prescribed drugs in the world and the most effective in hypothyroidism treatment. The presence of LTX in the environment has become a matter of major concern due to the widespread use of this hormone and by the fact that it is only partially removed in conventional water and sewage treatment plants. However, information regarding the photochemical fate of this hormone in environmental or engineered systems is scarce in the literature. In this work, the sunlight-driven direct and indirect LTX degradation was investigated by determining the photolysis quantum yield, ΦLTX = 3.80 (± 0.02) × 10−5, as well as the second-order kinetic constants of the reactions with hydroxyl radicals, kLTX,•OH = 1.50 (± 0.01) × 1010 L mol−1 s−1 and singlet oxygen, kLTX,1O2 = 1.47 (± 0.66) × 108 L mol−1 s−1. Mathematical simulations indicate that LTX photodegradation is favored in shallow, nitrite-rich, and dissolved organic matter (DOM)-poor environments, with LTX half-life times varying from less than 10 days to about 80 days. LTX removals of 85 and 95% were achieved by UVC photolysis and UVC/H2O2 after 120 min, respectively. Three transformation products, triiodothyronine, diiodothyronine, and diiodotyrosine, were identified during LTX degradation by the UVC-based processes studied. The results herein regarding photo-induced kinetics coupled with environmental fate simulations may help evaluate LTX persistence and also the design of water and wastewater treatment processes.
Removal mechanism of sulfamethazine and its intermediates from water by a rotating advanced oxidation contactor equipped with TiO 2 –high-silica zeolite composite sheets
Abstract
The removal of antibiotic sulfamethazine (SMT) and its intermediates from water was investigated using a rotating advanced oxidation contactor (RAOC) equipped with TiO2-high-silica zeolite composite sheets. SMT was readily removed from water through adsorption onto high-silica zeolite and photocatalytic decomposition by TiO2 inside the composite sheet. Some degradation intermediates were retained and photocatalytically decomposed inside the composite sheet. Relatively hydrophobic intermediates such as hydroxylated SMT were captured inside the sheets, whereas hydrophilic intermediates were distributed in water. This was attributed to the hydrophobic interactions in the adsorption mechanism of high-silica zeolite. The time courses of the NH4+, NO3−, and SO42− ion concentration during the RAOC treatment of SMT were evaluated. After treatment by RAOC for 24 h, approximately 94% of nitrogen derived from the amino and sulfanilamide groups and 39% of sulfur from the sulfanilamide group were mineralized, which indicated that the mineralization behavior of SMT treated by RAOC was different from that treated by TiO2 powder. These results strongly suggested that the dissociation of the amino group and cleavage of the sulfonamide group and subsequent dissociation of the amino group preferentially proceeded inside the composite sheets.
Fibroepitelioma de Pinkus: un carcinoma basocelular con una dermoscopia distintiva
Publication date: Available online 14 August 2018
Source: Actas Dermo-Sifiliográficas
Author(s): C. Cuenca-Barrales, J.C. Ruiz-Carrascosa, R. Ruiz-Villaverde
Thylacospermum caespitosum population structure and cushion species community diversity along an altitudinal gradient
Abstract
As alpine plants, cushion species are particularly susceptible to environment changes. Thus, understanding population structure and community diversity variation of cushion plants along elevational gradients is crucial for estimating their response to predicted climate changes. In this study, Thylacospermum caespitosum populations from three elevations (low, medium, and high) in three climate zones of China (the Kunlun, Qilian, and Tianshan Mountains) were selected to evaluate the effect of elevation on the structure of T. caespitosum populations and species diversity of cushion communities. Results showed that elevation substantially influenced T. caespitosum populations (size structure, density, and death rate), as well as richness (α-diversity) and microhabitat species pool (species pool) of cushion communities. In the low elevations, T. caespitosum populations were in decline due to a lower ratio of small plants and higher mortality compared with populations at medium and high elevations. The α-diversity and species pool in cushion communities were significantly increased with decreased elevation, but the importance value of T. caespitosum decreased accordingly. Moreover, there was a significant positive correlation between elevation and relative importance value (the importance of one species in the community) of T. caespitosum (r = 0.883; P < 0.01). Elevation was significantly negatively correlated with the mortality rate of T. caespitosum (r = − 0.855; P < 0.01), α-diversity (r = − 0.933; P < 0.001), and species pool (r = − 0.885; P < 0.01). The declining characters of T. caespitosum population structure were obvious in low elevation populations. This decline may directly or indirectly relate to environmental change. Effects of elevation can provide an early indication of range contractions and population declines of cushion species with future climate warming. We call for more mechanistic studies of climate change impacts on cushion populations, particularly in alpine systems near the snow line.
Wastewater-based epidemiology in low Human Development Index states: bias in consumption monitoring of illicit drugs
Abstract
Wastewater-based epidemiology is a promising approach worldwide, and its application is currently being developed in non-advanced economies. This technology, based on known toxicokinetic data initially used to detect illicit drugs in well-managed and maintained local sewer networks, has been extended to assess other products such as pesticides, alcohol, flame retardants, nicotine, and other substances. This technology is also used in countries with non-advanced economies. The present review aims to support future wastewater-based epidemiology in such countries by providing toxicokinetic data for locally used narcotic drugs that are expected or known to be emerging in developed countries, outlining the excretion differences due to human polymorphism, and summarising the practical obstacles due to the coverage, maintenance efficiency, or type of local sewage network.Case study feedback from Martinique is presented as an example; the Martinique field study complies with the Organisation for Economic Co-operation and Development standards for health issues, but not with regard to population and urban dynamics.
Primary Angioplasty without Stenting for Symptomatic, High-Grade Intracranial Stenosis with Poor Circulation [INTERVENTIONAL]
BACKGROUND AND PURPOSE:
Although the Stenting versus Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) study demonstrated a high incidence of perioperative complications for Intracranial Atherosclerotic disease (ICAD) treatments with stent placement, some studies have shown that submaximal angioplasty with an undersized balloon limits the risks of perioperative complications, suggesting that intervention may remain an alternative option for ICAD if perioperative complications are minimized. We sought to evaluate clinical and angiographic outcomes after primary angioplasty without stent placement in patients with symptomatic, high-grade intracranial stenosis and poor antegrade flow who were refractory to medical therapy.
MATERIALS AND METHODS:All cases with high-grade, symptomatic intracranial stenosis and poor antegrade flow treated with intracranial angioplasty without stent placement at Xuanwu Hospital, Capital Medical University, from January 2010 to December 2016, were retrospectively reviewed. The main outcomes included the changes in antegrade flow and residual stenosis and any stroke or death within 1 month. We also evaluated functional outcomes, stroke, and restenosis in patients on follow-up.
RESULTS:Thirty-five patients (mean age, 64.3 years) were included, and the mean follow-up time was 9.7 months. The average preprocedural stenosis was 88.4%. The immediate, average postprocedure stenosis rate was 25.3%, and the average postprocedural stenosis rate at last angiographic follow-up was 34.7%. The primary end point of major stroke or death at 30 days was observed in 1 patient (1/35, 2.9%), and no patient had intraprocedural complications. The incidence of stroke or death at the last follow-up was 2.9%, which was superior to the results of the medical and stent-placement arms of the SAMMPRIS study. Severe restenosis was observed in 3 (3/25, 12%) patients but without any symptoms.
CONCLUSIONS:In this retrospective series, primary balloon angioplasty was an effective treatment option for symptomatic intracranial stenosis with a high risk of stroke.
Zonally Magnified Oblique Multislice and Non-Zonally Magnified Oblique Multislice DWI of the Cervical Spinal Cord [SPINE]
BACKGROUND AND PURPOSE:
The zonally magnified oblique multislice EPI (ZOOM-EPI) diffusion-weighted sequence has been visually shown to provide superior MR diffusion image quality compared with the full-FOV single-shot EPI sequence (non-ZOOM-EPI) in the adult cervical spinal cord. The purpose of this study was to examine the diffusion tensor imaging indices in the normal human cervical spinal cord between ZOOMED and non-ZOOMED DTI acquisitions and determine whether DTI values are comparable between direct and indirect age-matched groups.
MATERIALS AND METHODS:Fifty-four subjects 23–58 years of age (9 direct age-matched and 45 indirect age-matched) were scanned using a 1.5T scanner. Diffusion tensor indices including fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity were generated from the DTI dataset. These DTI values were calculated for both ZOOM and non-ZOOM acquisitions and compared at each intervertebral disc level. The variability of the DTI values for ZOOM and non-ZOOM sequences was measured using a coefficient of variation within direct and indirect age-matched controls.
RESULTS:The mean diffusivity, axial diffusivity, and radial diffusivity values obtained along the cervical spinal cord in the age-matched controls showed a significant decrease using the ZOOM sequence (P = .05, P = .002, and P < .001). Mean fractional anisotropy showed a significant increase (P = .04) using the ZOOM sequence. The indirect age-matched controls showed a statistically significant increase in fractional anisotropy (P = .03) and a decrease in mean diffusivity (P = .002), axial diffusivity (P < .001), and radial diffusivity (P = .002) using the ZOOM sequence. Less variability has been shown in DTI using the ZOOM sequence compared with the non-ZOOM sequence in both direct and indirect age groups. The ZOOM sequence exhibited higher SNR (SNRZOOM = 22.84 ± 7.59) compared with the non-ZOOM sequence (SNRnon-ZOOM = 19.7 ± 7.05). However, when we used a 2-tailed t test assuming unequal variances, the ZOOM sequence did not demonstrate a statistically significant increase.
CONCLUSIONS:ZOOM DTI acquisition methods provide superior image quality and precision over non-ZOOM techniques and are recommended over conventional full-FOV single-shot EPI DTI for clinical applications in cervical spinal cord imaging.
Prognostic Implications of Gadolinium Enhancement of Skull Base Chordomas [HEAD & NECK]
BACKGROUND AND PURPOSE:
Skull base chordomas often demonstrate variable MR imaging characteristics, and there has been limited prior research investigating the potential clinical relevance of this variability. The purpose of this retrospective study was to assess the prognostic implications of signal intensity on standard imaging techniques for the biologic behavior of skull base chordomas.
MATERIALS AND METHODS:Medical records were retrospectively reviewed for 22 patients with pathologically confirmed skull base chordomas. Clinical data were recorded, including the degree of surgical resection, the presence or absence of radiation therapy, and time to progression/recurrence of the tumor or time without progression/recurrence of the tumor following initial treatment. Pretreatment imaging was reviewed for the presence or absence of enhancement and the T2 signal characteristics. Tumor-to-brain stem signal intensity ratios on T2, precontrast T1, and postcontrast T1 spin-echo sequences were also calculated. Statistical analysis was then performed to assess correlations between imaging characteristics and tumor progression/recurrence.
RESULTS:Progression/recurrence of skull base chordomas was seen following surgical resection in 11 of 14 (78.6%) patients with enhancing tumors and in zero of 8 patients with nonenhancing tumors. There was a statistically significant correlation between skull base chordoma enhancement and subsequent tumor progression/recurrence (P < .001), which remained significant after controlling for differences in treatment strategy (P < .001). There was also a correlation between postcontrast T1 signal intensity (as measured by postcontrast T1 tumor-to-brain stem signal intensity ratios) and recurrence/progression (P = .02). While T2 signal intensity was higher in patients without tumor progression (median tumor-to-brain stem signal intensity ratios on T2 = 2.27) than in those with progression (median tumor-to-brain stem signal intensity ratios on T2 = 1.78), this association was not significant (P = .12).
CONCLUSIONS:Enhancement of skull base chordomas is a risk factor for tumor progression/recurrence following surgical resection.
Morphology-Specific Discrimination between MS White Matter Lesions and Benign White Matter Hyperintensities Using Ultra-High-Field MRI [ADULT BRAIN]
BACKGROUND AND PURPOSE:
Recently published North American Imaging in Multiple Sclerosis guidelines call for derivation of a specific radiologic definition of MS WM lesions and mimics. The purpose of this study was to use SWI and magnetization-prepared FLAIR images for sensitive differentiation of MS from benign WM lesions using the morphologic characteristics of WM lesions.
MATERIALS AND METHODS:Seventeen patients with relapsing-remitting MS and 18 healthy control subjects were enrolled retrospectively. For each subject, FLAIR and multiecho gradient-echo images were acquired using 7T MR imaging. Optimized postprocessing was used to generate single-slice SWI of cerebral veins. SWI/FLAIR images were registered, and 3 trained readers performed lesion assessment. Morphology, location of lesions, and the time required for assessment were recorded. Analyses were performed on 3 different pools: 1) lesions of >3 mm, 2) nonconfluent lesions of >3 mm, and 3) nonconfluent lesions of >3 mm with no or a single central vein.
RESULTS:The SWI/FLAIR acquisition and processing protocol enabled effective assessment of central veins and hypointense rims in WM lesions. Assessment of nonconfluent lesions with ≥1 central vein enabled the most specific and sensitive differentiation of patients with MS from controls. A threshold of 67% perivenous WM lesions separated patients with MS from controls with a sensitivity of 94% and specificity of 100%. Lesion assessment took an average of 12 minutes 10 seconds and 4 minutes 33 seconds for patients with MS and control subjects, respectively.
CONCLUSIONS:Nonconfluent lesions of >3 mm with ≥1 central vein were the most sensitive and specific differentiators between patients with MS and control subjects.
Application of Reduced-FOV Diffusion-Weighted Imaging in Evaluation of Normal Pituitary Glands and Pituitary Macroadenomas [ADULT BRAIN]
BACKGROUND AND PURPOSE:
FOV optimized and constrained undistorted single-shot imaging provides relatively high-resolution images with few artifacts. This study evaluated the image quality and value of FOV optimized and constrained undistorted single-shot DWI in the evaluation of normal pituitary glands and pituitary macroadenomas.
MATERIALS AND METHODS:Subjects with normal pituitary glands and patients with pituitary macroadenomas underwent FOV optimized and constrained undistorted single-shot and EPI DWI. Two neuroradiologists graded the image quality based on visualization of the pituitary stalk, pituitary gland, and pituitary macroadenoma. Intra- and interobserver agreements were assessed by statistics. Image quality and ADCs were compared between the 2 methods by the paired Wilcoxon signed rank test and t test. Differences in ADC between normal pituitary glands and macroadenomas were analyzed by the independent-samples t test.
RESULTS:Twenty-eight subjects with normal pituitary glands and 16 patients with macroadenomas were enrolled. Intra- and interobserver agreements for image-quality assessment were moderate to substantial. Relative to EPI DWI, FOV optimized and constrained undistorted single-shot DWI exhibited obviously better image quality both in normal pituitary glands and macroadenomas. There was no significant difference in ADCs of macroadenomas between the 2 methods. Macroadenomas with soft consistency (0.75 ± 0.14 x 10–3 mm2/s) had significantly lower mean ADC than normal pituitary glands (1.18 ± 0.19 x 10–3 mm2/s; P < .001).
CONCLUSIONS:FOV optimized and constrained undistorted single-shot DWI helps acquire high-resolution images of normal pituitary glands and pituitary macroadenomas with relatively few susceptibility artifacts in a clinically feasible scan time. This sequence might be helpful for evaluating the consistency of pituitary macroadenomas.
Assessing Corticospinal Tract Asymmetry in Unilateral Polymicrogyria [PEDIATRICS]
BACKGROUND AND PURPOSE:
Asymmetry of the corticospinal tract in congenital lesions is a good prognostic marker for preserved motor function after hemispherectomy. This study aimed to assess this marker and provide a clinically feasible approach in selected cases of unilateral polymicrogyria.
MATERIALS AND METHODS:Corticospinal tract asymmetry of 9 patients with unilateral polymicrogyria substantially affecting the central region was retrospectively assessed on axial T1WI and DTI. Volumes of the brain stem and thalamus and DTI parameters of the internal capsule were measured. Two neuroradiologists independently rated the right-left asymmetry at 4 levels along the corticospinal tract. DTI tractography was used to determine the motor cortex within polymicrogyria, with task-based functional MR imaging available in 3/9 cases.
RESULTS:Visual assessment of the brain stem asymmetry showed excellent correlation with quantitative measures on both T1WI and color-coded DTI maps (P = .007 and P = .023). Interrater reliability regarding structural and DTI-based corticospinal tract asymmetry was best at the midbrain (Cohen = 0.77, P = .018). Three patients underwent functional hemispherectomy with postsurgical stable motor function, all showing marked corticospinal tract asymmetry preoperatively. Following the DTI-based corticospinal tract trajectories allowed identifying the presumed primary motor region within the dysplastic cortex in 9/9 patients, confirmed by functional MR imaging in 3/3 cases.
CONCLUSIONS:Visual assessment of corticospinal tract asymmetry in unilateral polymicrogyria involving the motor cortex is most reliable with T1WI and color-coded DTI maps at the level of the midbrain. Pronounced asymmetry predicts preserved motor function after hemispherectomy. DTI-based tractography can be used as a guidance tool to the motor cortex within polymicrogyria.
Neurodevelopmental Correlates of Fetal Motor Behavior Assessed Using Cine MR Imaging [PEDIATRICS]
BACKGROUND AND PURPOSE:
Fetal motor behavior is widely used as a clinical indicator for healthy development; however, our understanding of its potential as a marker for neurologic integrity is underdeveloped. MR imaging allows complete views of the whole fetus, which, combined with brain imaging, may improve the characterization of this relationship. This study aimed to combine an analysis of fetal motor behavior, brain MR imaging, and postnatal outcome, to provide insight into neurodevelopmental correlates of motor behavior.
MATERIALS AND METHODS:Cine MR imaging was used to acquire sequences of fetal motor behavior in subjects with normal and abnormal findings on conventional brain MR imaging between 18 weeks' gestation and term. General movement sequences were analyzed using established criteria. Brain MR imaging was reported by an expert fetal neuroradiologist. Subjects were followed for up to 4 years postnatally with standard postnatal assessments.
RESULTS:Nineteen of 21 fetuses with normal brain MR imaging findings showed normal general movements, compared with 14 of 22 of the fetuses with abnormal brain MR imaging findings, which, when classified by severity of the malformation, showed a significant relationship with postnatal outcome (P = .021). There was a significant relationship among neurodevelopmental outcome, general movement quality, and MR imaging of the brain (P = .020).
CONCLUSIONS:The findings from this study demonstrate that a combined structural and functional imaging approach to the fetus will improve the characterization of early neurologic integrity, with the potential to inform postnatal outcome. This also lays the groundwork for further in vivo research as advanced imaging techniques are developed to study fetal neurologic development.
The Bone Does Not Predict the Brain in Sturge-Weber Syndrome [PEDIATRICS]
BACKGROUND AND PURPOSE:
It has been hypothesized that skull marrow signal alteration may represent an early disease manifestation of Sturge-Weber syndrome before development of its intracranial manifestations. We alternatively hypothesized that intraosseous changes are associated with the overlying port-wine stain rather than the intracranial stigmata of Sturge-Weber syndrome and hence are not a predictor of brain involvement.
MATERIALS AND METHODS:MR imaging of children presenting with port-wine stain and/or Sturge-Weber syndrome between 1998 and 2017 was evaluated by 2 pediatric neuroradiologists for marrow signal abnormality and pial angioma and other Sturge-Weber syndrome features: ocular hemangioma, atrophy, and white matter changes (advanced myelination). Groups were divided into port-wine stain–only (without intracranial Sturge-Weber syndrome features) and Sturge-Weber syndrome (the presence of cerebral pial angioma). The 2 test was performed to evaluate the association between port-wine stain and bone marrow changes and between osseous change and pial angioma.
RESULTS:We reviewed 139 cases: 40 with port-wine stain–only and 99 with Sturge-Weber syndrome with pial angioma. Fifteen of 99 cases of Sturge-Weber syndrome had no port-wine stain. In the port-wine stain–only cohort, 78% had ipsilateral bony changes and 17% had no intraosseous changes. In the Sturge-Weber syndrome cohort, 84/99 had associated port-wine stain, 91% (P < .01) had bony changes ipsilateral to the port-wine stain or had no bone changes in the absence of port-wine stain, and 77% (P = .27) had bony changes ipsilateral to a cerebral pial angioma. Eighty percent of patients with Sturge-Weber syndrome who lacked a port-wine stain also lacked marrow changes. Five patients with bilateral port-wine stain and bilateral marrow changes had only a unilateral pial angioma.
CONCLUSIONS:Intraosseous marrow changes are strongly associated with facial port-wine stain; no significant association was found between pial angioma and bone marrow changes.
Clinical Utility of a Novel Ultrafast T2-Weighted Sequence for Spine Imaging [SPINE]
BACKGROUND AND PURPOSE:
TSE-based T2-weighted imaging of the spine has long scan times. This work proposes a fast imaging protocol using variable refocusing flip angles, optimized for blurring and specific absorption rate.
MATERIALS AND METHODS:A variable refocusing flip angle echo-train was optimized for the spine to improve the point spread function and minimize the specific absorption rate, yielding images with improved spatial resolution and SNR compared with the constant flip angle sequence. Data were acquired from 51 patients (35 lumbar, 16 whole-spine) using conventional TSE and the proposed sequence, with a single-shot variant for whole-spine. Noninferiority analysis was performed to evaluate the efficiency of the proposed technique.
RESULTS:The proposed multishot sequence resulted in a 2x shorter scan time with a >1.5x lower specific absorption rate. The variable flip angle sequence was noninferior to the conventional TSE (P < .025) for all image-quality and clinical criteria except signal-to-noise ratio for the lumbar spine protocol. However, mean image scores for the TSE-variable refocusing flip angle were ≥4.3 for all criteria, and concordance analysis showed high agreement (>90%) with the TSE, indicating clinical equivalence. The single-shot sequence resulted in 4x shorter whole-spine scans, and image scores were ≥4.4 for all criteria, attesting to its clinical utility.
CONCLUSIONS:We present a fast T2-weighted spine protocol using variable refocusing flip angles, including a single-shot variant. The sequences have better point spread function behavior than their constant flip angle counterparts and, being faster, should be less sensitive to patient motion, often seen in the longer TSE scans.
Resting-State Functional MRI: Everything That Nonexperts Have Always Wanted to Know [FUNCTIONAL]
SUMMARY:
Resting-state fMRI was first described by Biswal et al in 1995 and has since then been widely used in both healthy subjects and patients with various neurologic, neurosurgical, and psychiatric disorders. As opposed to paradigm- or task-based functional MR imaging, resting-state fMRI does not require subjects to perform any specific task. The low-frequency oscillations of the resting-state fMRI signal have been shown to relate to the spontaneous neural activity. There are many ways to analyze resting-state fMRI data. In this review article, we will briefly describe a few of these and highlight the advantages and limitations of each. This description is to facilitate the adoption and use of resting-state fMRI in the clinical setting, helping neuroradiologists become familiar with these techniques and applying them for the care of patients with neurologic and psychiatric diseases.
Forecasting CO 2 emissions in Hebei, China, through moth-flame optimization based on the random forest and extreme learning machine
Abstract
The surge of carbon dioxide emission plays a dominant role in global warming and climate change, posing an enormous threat to the development of human being and a profound impact on the global ecosystem. Thus, it is essential to analyze the carbon dioxide emission change trend through an accurate prediction to inform reasonable energy-saving emission reduction measures and effectively control the carbon dioxide emission from the source. This paper proposed a hybrid model by combining the random forest and extreme learning machine together for the carbon dioxide emission forecasting in this paper; the random forest is applied for influential factors analysis and the extreme learning machine for the prediction. To improve the performance of the prediction model, moth-flame optimization is adopted to optimize initial weight and bias in extreme learning machine. A case study whose data is derived from Hebei Province, China, during the period 1995–2015 is conducted to verify the effectiveness of the proposed model. Results show that the novel model outperforms the compared parallel models in carbon dioxide emission prediction and has the potential to improve the accuracy of CO2 emission forecasting.
Canonical Causal Diagrams to Guide the Treatment of Missing Data in Epidemiological Studies
Abstract
With incomplete data, the missing at random (MAR) assumption is widely understood to enable unbiased estimation with appropriate methods. The need to assess the plausibility of MAR and to perform sensitivity analyses considering missing not at random (MNAR) scenarios have been emphasized, but the practical difficulty of these tasks is rarely acknowledged. What MAR means with multivariable missingness is difficult to grasp, while in many MNAR scenarios unbiased estimation is possible using methods commonly associated with MAR. Directed acyclic graphs (DAGs) have been proposed as an alternative framework for specifying practically accessible assumptions beyond the MAR-MNAR dichotomy. However, there is currently no general algorithm for deciding how to handle the missing data given a specific DAG. We construct "canonical" DAGs capturing typical missingness mechanisms in epidemiological studies with incomplete exposure, outcome and confounders. For each DAG, we determine whether common target parameters are "recoverable", meaning that they can be expressed as functions of the observed data distribution and thus estimated consistently, or if sensitivity analyses are necessary. We investigate the performance of available case and multiple imputation procedures. Using the Longitudinal Study of Australian Children, we illustrate how our findings can guide the treatment of missing data in point-exposure studies.Evidence of latent molecular diversity determining the virulence of community‐associated MRSA USA300 clones in mice
Immunity, Inflammation and Disease, EarlyView.
Issue Information
Pigment Cell &Melanoma Research, Volume 31, Issue 5, Page 549-553, September 2018.
Monozygotic twins with group C xeroderma pigmentosum due to a compound heterozygous mutation in XPC gene
The Journal of Dermatology, EarlyView.
Gut microbiota alterations in moderate to severe acne vulgaris patients
The Journal of Dermatology, EarlyView.
Severe thiopurine‐induced leukocytopenia and hair loss in Japanese patients with defective NUDT15 variant: Retrospective case–control study
The Journal of Dermatology, EarlyView.
Bullous CD4+ CD8+ Adult T‐Cell Leukemia/Lymphoma, A Rare Diagnostically Challenging Cutaneous Variant
Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.
Incidental diagnosis of blastic plasmacytoid dendritic cell neoplasm in skin excision for basal cell carcinoma
Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.
Aneurysmal Fibrous Histiocytomas with Recurrent Rearrangement of the PRKCD Gene and LAMTOR1‐PRKCD Fusions
Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.
Onycholemmal carcinoma with prominent dystrophic calcification and review of the literature
Journal of Cutaneous Pathology, Volume 45, Issue 9, Page 643-646, September 2018.
Recurrent ulceronecrotic plaques and nodules with spontaneous remission
JDDG: Journal der Deutschen Dermatologischen Gesellschaft, EarlyView.
Information‐seeking and use of information resources among melanoma patients of German skin cancer centers
JDDG: Journal der Deutschen Dermatologischen Gesellschaft, EarlyView.
Treatment of inflammatory linear verrucous epidermal nevus pruritus with thalidomide
JDDG: Journal der Deutschen Dermatologischen Gesellschaft, EarlyView.
Steric Demand and Rate‐Determining Step for Photoenolization of Di‐ortho‐Substituted Acetophenone Derivatives
Photochemistry and Photobiology, Volume 0, Issue ja, -Not available-.
Microbiological Decontamination of Water: Improving the Solar Disinfection Technique (SODIS) with the Use of Non‐toxic Vital Dye Methylene Blue
Photochemistry and Photobiology, Volume 0, Issue ja, -Not available-.
Chiral Inductions in Excited State Reactions: Photodimerization of Alkyl 2‐Naphthoates as a Model
Photochemistry and Photobiology, Volume 0, Issue ja, -Not available-.
Regulation of Melanopsin Signalling: Key Interactions of the Non‐visual Photopigment
Photochemistry and Photobiology, Volume 0, Issue ja, -Not available-.
Tetracycline Removal Under Solar Illumination Over Ag3VO4/mpg‐C3N4 Heterojunction Photocatalysts
Photochemistry and Photobiology, Volume 0, Issue ja, -Not available-.
Effects and Mechanism of Nicotinamide Against UVA‐ and/or UVB‐mediated DNA Damages in Normal Melanocytes
Photochemistry and Photobiology, Volume 0, Issue ja, -Not available-.
Pathogenic genes related to the progression of actinic keratoses to cutaneous squamous cell carcinoma
International Journal of Dermatology, EarlyView.
An inside look at prurigo pigmentosa: case report from Ukraine
International Journal of Dermatology, EarlyView.
Sex hormones, erectile dysfunction, and psoriasis; a bad friendship!
International Journal of Dermatology, EarlyView.
Combining microneedling with other minimally invasive procedures for facial rejuvenation: a split‐face comparative study
International Journal of Dermatology, EarlyView.
Lymphedema in patients with hidradenitis suppurativa: a systematic review of published literature
International Journal of Dermatology, EarlyView.
Resident experiences with social media: modernizing dermatology training
International Journal of Dermatology, EarlyView.
Prevalence, risk factors, and mortality outcome in the drug reaction with eosinophilia and systemic symptoms patients with cardiac involvement
International Journal of Dermatology, EarlyView.
Hemoglobin as an indicator of disease activity in severe hidradenitis suppurativa
International Journal of Dermatology, EarlyView.
Pemphigus vulgaris with vegetating feature confined to the scalp
International Journal of Dermatology, EarlyView.
Secondary syphilis presented with impetigo‐like lesions: a rare case report
International Journal of Dermatology, EarlyView.
Unusual hair findings in a child with cardiofaciocutaneous syndrome
International Journal of Dermatology, EarlyView.
Euromelanoma in Portugal. How useful was the Euromelanoma campaign between 2010 and 2017?
International Journal of Dermatology, EarlyView.
Single question burden of disease assessment in patients referred for patch testing
International Journal of Dermatology, EarlyView.
Atezolizumab‐associated vitiligo‐like leukoderma in a patient with transitional cell carcinoma
International Journal of Dermatology, EarlyView.
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