Abstract
Matthew Kieran has recently argued that those he calls 'appreciative snobs' go wrong by valuing appreciative objects primarily because of their ability to raise the snob's social status, what I call social contagion snobbery. In this paper, I argue that there are at least two other ways that snobbery commonly manifests itself in appreciative contexts, what I call attitudinal snobbery and contextual snobbery. As it turns out, all three snobs—Kieran's social-contagion snob, the attitudinal snob, and the contextual snob—represent distinct ways that appreciative judgments can go wrong because of how socio-hierarchical elements figure into the snob's appreciative judgments.Παρασκευή 7 Σεπτεμβρίου 2018
Journals Received
JTLA, Journal of the Faculty of Letters, The University of Tokyo: Prolegomena, Society for the Advancement of Philosophy, Aesthetics. University of Zagreb.
Books Received
ABBOTT, MATHEW. Michael Fried and Philosophy: Modernism, Intention, and Theatricality. (London: Routledge). 2018. pp. 267. £115 (hbk).
Notes on Contributors
ZED ADAMS is Associate Professor of Philosophy at the New School, New York. He is the author of On the Genealogy of Color: A Case Study in Historicized Conceptual Analysis (Routledge, 2016) and the co-editor of Giving a Damn: Essays in Dialogue with John Haugeland (MIT Press, 2017).
Microbial explanations for field-aged biochar mitigating greenhouse gas emissions during a rice-growing season
Abstract
Knowledge about the impacts of fresh and field-aged biochar amendments on greenhouse gas (CH4, N2O) emissions is limited. A field experiment was initiated in 2012 to study the effects of fresh and field-aged biochar additions on CH4 and N2O emissions and the associated microbial activity during the entire rice-growing season in typical rice-wheat rotation system in Southeast China. CH4 and N2O fluxes were monitored, and the abundance of methanogen (mcrA), methanotrophy (pmoA), ammonia-oxidizing archaea (AOA), ammonia-oxidizing bacteria (AOB), nitrite reductase (nirS, nirK), N2O reductase (nosZ), and potential soil enzyme activities related to CH4 and N2O were simultaneously measured throughout different rice developmental stages. There were three treatments: control (urea without biochar), fresh BC (urea with fresh biochar added in 2015), and aged BC (urea with 3-year field-aged biochar added in 2012). Results showed that field-aged biochar significantly decreased seasonal CH4 emissions by 16.8% in relation to the fresh biochar, though no significant differences were detected between biochars and control treatment. The structural equation model indicated that soil pH, microbial biomass carbon (MBC), pmoA, and mcrA were the main factors directly influenced by fresh and aged biochar amendments; aged biochar showed a negative effect while fresh biochar showed positive effects on CH4 fluxes. Both fresh and field-aged biochar obviously increased AOA and AOB abundances and reduced the (nirS+nirK)/nosZ ratio during the entire rice-growing season, although no significant effects were observed on seasonal N2O emissions. Therefore, biochar amendment produced long-term effects on total CH4 and N2O emissions through observed influences of soil pH and functional gene abundance.
The figure shows how fresh and field-aged biochar differentially affected CH4 production and oxidation and N2O production and reduction through related functional gene abundances. Blue arrows indicate suppressing while pink arrows indicate promoting effect.
Biofilter with mixture of pine bark and expanded clay as packing material for methane treatment in lab-scale experiment and field-scale implementation
Abstract
Low methane (CH4) emission reduction efficiency (< 25%) has been prevalent due to inefficient biological exhaust gas treatment facilities in mechanic biological waste treatment plants (MBTs) in Germany. This study aimed to quantify the improved capacity of biofilters composed of a mixture of organic (pine bark) and inorganic (expanded clay) packing materials in reducing CH4 emissions in both a lab-scale experiment and field-scale implementation. CH4 removal performance was evaluated using lab-scale biofilter columns under varied inflow CH4 concentrations (70, 130, and 200 g m−3) and corresponding loading rates of 8.2, 4.76, and 3.81 g m−3 h−1, respectively. The laboratory CH4 removal rates (1.2–2.2 g m−3 h−1) showed positive correlation with the inflow CH4 loading rates (4–8.2 g m−3 h−1), indicating high potential for field-scale implementation. Three field-scale biofilter systems with the proposed mixture packing materials were constructed in an MBT in Neumünster, northern Germany. A relatively stable CH4 removal efficiency of 38–50% was observed under varied inflow CH4 concentrations of 28–39 g m−3 (loading rates of 1120–2340 g m−3 h−1) over a 24-h period. The CH4 removal rate was approximately 500–700 g m−3 h−1, which was significantly higher than relevant previously reported field-scale biofilter systems (16–50 g m−3 h−1). The present study provides a promising configuration of biofilter systems composed of a mixture of organic (pine bark) and inorganic (expanded clay) packing materials to achieve high CH4 emission reduction.
Graphic abstract
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Effects of particulate matter (PM2.5) and associated acidity on ecosystem functioning: response of leaf litter breakdown
Abstract
Particulate matter (PM2.5 with the diameter ≤ 2.5 μm) as one of the most harmful and complex pollutants can reduce environment quality and affect human health. Through acidification by wet deposition, PM2.5 can cause acid rain to impact aquatic ecosystems. However, our understanding of PM2.5 effect on ecosystem functioning is highly limited. This study investigated the relationship between PM2.5 concentration, associated acidity, and leaf litter breakdown of three tree species in laboratory experimental mesocosms, which are weeping willow (Salix babylonica), camphor tree(Cinnamomum camphora), and the south magnolia (Magnolia grandiflora). We found that leaf litter breakdown was significant affected by PM2.5 and associated acidity. With the increase of acidity, the leaf breakdown rate of all three tree species decreased. With the increase of PM2.5 concentration, the leaf breakdown rates of those leaves slowed down. When considering the influence of leaf toughness, willow leaves with lower toughness had a higher breakdown rate than that of camphor tree and the south magnolia. Our study suggests that PM2.5 has significant impact on the aquatic ecosystem functioning through increasing acidification in aquatic environment. Hence, along with ecological restoration of local aquatic habitats, further freshwater ecosystem management should include reducing air pollution through regional efforts of best ecosystem management.
Financial development, globalization, and CO 2 emission in the presence of EKC: evidence from BRICS countries
Abstract
This study examines the impact of energy consumption, financial development, globalization, economic growth, and urbanization on carbon dioxide emissions in the presence of Environmental Kuznets Curve (EKC) model for BRICS economies, by using a family of econometric techniques robust to heterogeneity and cross-sectional dependence. Results from LM test, CIPS and CADF unit root test, Westerlund Cointegration test, the Dynamic seemingly unrelated regression (DSUR), and Dumitrescu-Hurlin Granger causality test show that (i) the data is cross sectionally dependent and heterogeneous; (ii) carbon dioxide emissions, energy consumption, financial development, globalization, economic growth, square of GDP and urbanization have integration of order one; (iii) the examined variables are co-integrated; (iv) energy consumption and financial development contribute to the carbon dioxide emissions whereas globalization and urbanization have negative but insignificant relationship with carbon dioxide emissions; (v) supports the EKC hypothesis in BRICS economies; (vi) bidirectional causality exists among energy consumption, financial development, economic growth and square of GDP with carbon dioxide emissions whereas globalization and urbanization have unidirectional relationship with carbon dioxide emissions. Since these panel techniques account for heterogeneity and cross-sectional dependence in their estimation procedure, the empirical results are robust and reliable for policy recommendations. Furthermore, this study also uses time series tests (ADF, P-P, and FMOLS) to find the empirical results for each of the country and finds mixed results. Empirical findings directed towards some important policy implications.
Reconstruction mammaire par lambeau dorsal épargnant le muscle grand dorsal (Muscle-Sparing Latissimus Dorsi, MSLD) associé à un lambeau d’avancement thoraco-abdominal et greffe de tissu adipeux autologue
Publication date: Available online 7 September 2018
Source: Annales de Chirurgie Plastique Esthétique
Author(s): A. Mojallal, F. Boucher
Résumé
Le lambeau de grand dorsal (Latissimus Dorsi ou LD) a été décrit pour la première fois par l'Italien Tansini en 1896 et publié en 1906 dans le cas d'une reconstruction de la paroi thoracique après amputation mammaire. L'utilisation du lambeau de grand dorsal dans toutes ses variantes est très fréquente en reconstruction mammaire. Dans ces indications, le muscle est prélevé pour permettre de vasculariser la palette cutanée et/ou apporter du volume au sein reconstruit. Lorsque le muscle est prélevé en totalité ou presque, sa fonction motrice est alors totalement perdue. Les séquelles fonctionnelles liées à la perte du muscle grand dorsal sont alors définitives. Tobin et al. ont montré que le muscle grand dorsal pouvait être séparé en deux lambeaux basés sur les divisions de l'artère thoracodorsale ; le concept d'épargne musculaire était alors posé (Muscle-Sparing Latissimus Dorsi [MSLD]). Le lambeau dorsal avec conservation du muscle (MSLD) tel que nous le prélevons n'emporte qu'une fine bandelette musculaire et préserve 95 % du muscle grand dorsal avec sa vascularisation et son innervation motrice. Cette technique est de levée rapide avec une morbidité du site donneur très faible. Les séquelles fonctionnelles et les complications postopératoires apparaissent limitées par rapport au prélèvement d'un grand dorsal complet quelle que soit la cicatrice dorsale. Le volume du sein à reconstruire est obtenu par plusieurs séances de greffe de tissu adipeux. Nous présentons ici les bases anatomiques et la technique chirurgicale du lambeau dorsal avec conservation du muscle grand dorsal associé à un lambeau thoraco-abdominal d'avancement et une greffe de tissu adipeux en reconstruction mammaire.
Summary
The Latissimus Dorsi flap (or LD flap) was first described by the Tansini in 1896 and published in 1906. It concerned a case of chest wall reconstruction after breast amputation. The use of the LD flap in all its variants is very frequent in breast reconstruction. In these indications, the muscle is harvested for skin paddle vascularization and/or for bringing volume to the reconstructed breast. When all or most of the muscle is taken, its motor function is completely lost. The functional sequelae due to the loss of the latissimus dorsi muscle are then definitive. Tobin et al. showed that the LD muscle can be separated into two flaps based on the division of the thoracodorsal artery; the concept of muscle-sparing was then posed (Muscle-Sparing Latissimus Dorsi [MSLD]). The MSLD as we perform now, concerns only a thin muscle strip and preserves 95% of the LD muscle with its vascularization and motor innervation. This technique is quick with very low donor site morbidity. The functional sequelae and postoperative complications appear limited compared to the harvest of a total LD whatever the posterior scar. The volume of the breast to be reconstructed is obtained by several sessions of fat grafting. We present here the anatomical bases and the surgical technique of the muscle-sparing latissimus dorsi associated with a thoracoabdominal advancement flap and fat grafting in breast reconstruction.
Réponse à l’article « Le portfolio de l’interne de chirurgie plastique. Un outil à la formation ». Un contexte à préciser, un point de vue à nuancer
Publication date: Available online 7 September 2018
Source: Annales de Chirurgie Plastique Esthétique
Author(s): V. Duquennoy-Martinot
Reconstruction mammaire autologue microchirurgicale par lambeau libre perforant aux dépens de l’artère epigastrique inférieure profonde (DIEP) : techniques classique et mini-invasive extra-péritonéale par laparoscopie
Publication date: Available online 7 September 2018
Source: Annales de Chirurgie Plastique Esthétique
Author(s): M. Hivelin, L. Lantieri
Résumé
Les lambeaux libres perforants permettent, avec une morbidité réduite, de reconstruire les seins avec les tissus cutanés et adipeux qui le composent, en dehors de la glande mammaire. Autologues, ces reconstructions évitent les risques d'infections sur matériels, de contractures capsulaires et de changements associés aux implants. Le lambeau libre DIEP décrit en 1994 et réduisant la morbidité sur les muscles droits des TRAM, n'utilise que la peau de la partie sous-ombilicale de l'abdomen et les vaisseaux épigastriques inférieurs profonds qui l'alimentent. Le prélèvement des vaisseaux épigastriques inférieurs profonds à leur origine nécessite au niveau des muscles droits l'ouverture de leur aponévrose sur 8 à 10 cm et leur éversion par traction, à risques de lésions de leurs nerfs moteurs et faiblesses pariétales. Nous avons développé depuis 2014 un prélèvement du DIEP mini-invasif laparoscopique rétromusculaire prépéritonéal qui permet de réduire l'ouverture de l'aponévrose des muscles droits de 70 % et évite les tractions sur leurs nerfs moteurs. Nous présentons ici la technique de prélèvement classique du lambeau DIEP puis les points spécifiques à la technique laparoscopique. Les reconstructions par DIEP requièrent une laxité abdominale suffisante pour transposer l'ombilic et sont indiqués chez toutes les patientes nécessitant un apport cutané, en particulier en reconstruction mammaire secondaire. Le volume autologue apporté par le DIEP, pérenne, suit les variations pondérales des patientes et permet une meilleure qualité de vie à long terme. La dissection laparoscopique mini-invasive du diep réduit encore la morbidité et probablement les risques à la paroi abdominale à long terme.
Summary
Perforator free flaps allow breast reconstructions « like with like » with skin and fat, excluding mammary gland, with a low morbidity. Those autologous reconstructions prevent material associated infections, capsular contracture and implant replacements, associated to breast reconstructions including implants. DIEP flap was described in 1994 to reduce the morbidity faced with TRAM flaps harvest. It only includes sub-umbilical skin and deep epigastric vessels. Deep inferior epigastric vessels harvest requires rectus abdominis muscle sheet opening and traction on rectus muscles, both associated with increased risks of abdominal bulges. Since 2014, we developed a minimally invasive DIEP harvest by totally extra-peritoneal laparoscopic dissection of epigastric vessels with a 70% reduction of aponeurosis opening and avoiding traction on rectus' motor nerves. We report both classic and minimally invasive DIEP harvest techniques. Bresat reconstructions by DIEP require that the ombilicus can be transposed and are indicated for all patients with need for skin inset, particularly secondary breast reconstructions. The reconstructed breast as a volume that follows patients weight variations and allows for improved quality of life on a long term. Its minimally invasive totally extra peritoneal harvest by laparoscopy, with or without robotic assistance, offers a reduced morbidity and might allows for reduced risks of abdominal wall weakness on a long-term.
La reconstruction mammaire par prothèse
Publication date: Available online 7 September 2018
Source: Annales de Chirurgie Plastique Esthétique
Author(s): A. Fitoussi
Résumé
La reconstruction mammaire par prothèse reste la plus utilisée dans le monde et même à tendance a de nouveau augmenter au détriment de lambeaux musculo-cutanés depuis l'utilisation quasi-systématique, depuis quelques années, des greffes adipocytaires (lipomodelage) avant et/ou après mise en place de l'implant. Cette technique, plus simple, est souvent préférée par les patientes qui souhaitent éviter les cicatrices et les douleurs à distance de la zone thoracique. L'utilisation de formes d'implants différents, de l'injection de graisse, de lambeaux d'avancement abdominal, de matrices biologiques ou synthétiques permettent d'améliorer nettement les résultats de ces reconstructions en secondaire ou en immédiat. Toutes ces techniques sont détaillées dans l'article suivant afin de montrer les différents artifices qui permettent de réaliser cette intervention avec le maximum de sécurité.
Summary
Breast reconstruction by prosthesis remains the most used in the world and even tends to increase again at the expense of musculo-cutaneous flaps since the systematic use, in recent years, of adipocytes grafts (lipofilling) before and/or after in place of the implant. This simpler technique is often preferred by patients who want to avoid scars and pain away from the chest area. The use of different implant forms, fat injection, abdominal advancement flaps, biological or synthetic matrices can significantly improve the results of these reconstructions in secondary or immediate. All these techniques are detailed in the following article to show the different devices that allow to achieve this intervention with maximum security.
Relevante Interaktionen von Analgetika und Koanalgetika mit onkologischen Systemtherapeutika – wann wird es gefährlich?
Zusammenfassung
Hintergrund
Schmerz ist ein gefürchtetes und zugleich auch das häufigste Symptom bei Krebspatienten. Gleichzeitig ist es aber etwas, für dessen Behandlung effektive und gut verträgliche Medikamente zur Verfügung stehen. Da behandlungsbedürftige Schmerzen in jeder Phase der Erkrankung auftreten können, werden Schmerztherapie und tumorgerichtete Systemtherapie häufig gleichzeitig durchgeführt. Während die Zahl der verfügbaren analgetisch wirksamen Substanzen seit Jahrzehnten stagniert (es wurden lediglich neue galenische Zubereitungen entwickelt), entwickelt sich der Markt der verfügbaren und oft hoch wirksamen Onkologika nahezu explosionsartig. Damit steigt auch die Wahrscheinlichkeit klinisch relevanter und u. U. sogar tödlicher „drug-drug-interactions". Ein Drittel aller ambulanten onkologischen Patienten soll ein Risiko für das Auftreten einer Interaktion haben. Eine Sonderstellung nimmt hierbei Methadon ein, für dessen Antitumorwirkung es bis dato keinen wissenschaftlichen Beweis gibt, wohl aber für sein hohes Risikoprofil.
Ziel
Ziel dieses Artikels ist die Sensibilisierung des Onkologen und Palliativmediziners für die Bedeutung von Interaktionen. Exemplarisch werden einzelne Interaktionen erläutert und bewertet. Keineswegs wird an dieser Stelle der Anspruch auf Vollständigkeit erhoben. Hierzu wird auf (frei verfügbare) Datenbanken verwiesen.
Material und Methoden
Dieser Beitrag wurde unter Bezug auf die wissenschaftlichen Fachinformationen der erwähnten Substanzen, klinische Erfahrungsberichte sowie unter Zuhilfenahme einschlägiger Interaktionsportale erstellt. Die Auswahl der Substanzen erfolgte auf der Basis langjähriger internistisch onkologischer Erfahrung und der S3-Leitlinie Schmerz des Leitlinienprogramms Onkologie der AWMF (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V.)
Reassessing the global mortality burden of the 1918 influenza pandemic.
Abstract
Mortality estimates of the 1918 influenza pandemic vary considerably, and recent estimates have suggested that there were 50-100 million deaths worldwide. We investigated the global mortality burden using an indirect estimation approach and two publically available datasets: the Human Mortality Database (13 countries) and data extracted from the records of the Statistical Abstract for British India. The all-cause Human Mortality Database allowed us to estimate mortality annually in 1916-1921 for detailed age groups. Three different calculation methods were applied to the data (low, medium and high scenarios) and we used a multilevel regression model to control for distorting factors (e.g. war and the underlying time trend in mortality). We found that total pandemic mortality was an estimated 15 million deaths worldwide in 1918 (2.5 million in 1919), after including the rates for British India and controlling for wars and the underlying mortality trend. Our validity analysis showed that simulations of total mortality above 25 million are not realistic based on the underlying mortality rates included in Human Mortality Database and in British India. Our results suggest that the global mortality impact of the 1918 pandemic was important (17.4 million) but not as severe as most frequently cited estimates.Acetaminophen (Paracetamol) Exposure During Pregnancy and Pubertal Development in Boys and Girls From a Nationwide Puberty Cohort
Abstract
This study explored the association between exposure to acetaminophen during pregnancy and pubertal development using data from 15,822 boys and girls in the longitudinal Puberty Cohort, nested within The Danish National Birth Cohort. Use of acetaminophen was reported three times during pregnancy and six months postpartum. In total, 54% of mothers indicated use at least once during pregnancy. Between 2012 and 2017, sons and daughters provided information on a wide range of pubertal milestones, including Tanner stages, axillary hair growth and age at menarche or voice break and first ejaculation, every six months from 11 years of age until full sexual maturation. Data were analyzed by a regression model for interval-censored data, providing adjusted mean monthly differences in age at attaining the pubertal milestones according to intrauterine cumulative (weeks) and trimester specific acetaminophen exposure. Our results suggested a tendency towards slightly earlier attainment of almost all studied markers of female pubertal development with increasing number of weeks of exposure (i.e., about 1.5–3 months earlier age at pubic hair, axillary hair and acne development comparing unexposed with those prenatally exposed for more than 12 weeks). Male pubertal development had no strong association with acetaminophen exposure.Erratum zu: Europäische PanCare-Studien zu Spätfolgen nach Krebs im Kindes- und Jugendalter
Erratum zu:
Der Onkologe 2018
https://ift.tt/2QbXCFC
Im vorletzten Abschnitt zur Überschrift „Projekte PanCareSurFup und PanCareLIFE" muss es korrekt heißen (Ergänzung in kursiv):
… Von den 25 datenbereitstellenden Einrichtungen wurden demografische, klinische (z. B. zur …
A Patch Testing Initiative for the Investigation of Allergic Contact Dermatitis in a UK Allergy Practice: A Retrospective Study
Publication date: Available online 7 September 2018
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Timothy J. Watts, Sophia Watts, David Thursfield, Rubaiyat Haque
Abstract
Background
Patch testing is the gold standard diagnostic tool for investigating allergic contact dermatitis (ACD). In the United Kingdom, patch testing has been historically confined to the dermatologist's office. Furthermore, detailed studies on patch testing by allergists are significantly underrepresented at the international level.
Objective
The objective of this study was to undertake a comprehensive evaluation of a patch testing initiative from an allergy practice; reporting on various patient characteristics, prevalence and relevance data, in addition to immediate hypersensitivity testing.
Methods
We undertook a retrospective analysis of 156 patients suspected of having contact dermatitis seen in our UK allergy practice between October 2016 and April 2018.
Results
Of the 156 patients patch tested (mean age 36.9 years, female 88%, white ethnicity 71.8%, atopy 68.6%), ACD was diagnosed overall in 49% of the cohort and ACD of current relevance was assigned to 31%. Our extended British standard series alone detected the responsible allergen in 87% of patients and the remaining 13% were detected from supplementary or own material testing alone. Most prevalent contact allergens were nickel (28.2%), p-Phenylenediamine (8.3%), cobalt (8.3%), methylisothiazolinone (5.8%) and hydroperoxides of linalool (4.5%) and limonene (4.5%). A history of occupationally related dermatitis (P=.004) and initial (pre-test) diagnosis of ACD (P<.001) were both significantly associated with relevant positive patch test reactions (atopy status was not associated P>.05).
Conclusion
ACD was detected in almost 50% of assessed patients and we highlight the importance of assessing relevance. Hydroperoxides of limonene and linalool are notable additions to the prevalence data. Patch testing should be incorporated into more allergy practices, although availability of training is a limiting factor.
Implementing Health Care Technology Research into Practice to Improve Adult Asthma Management
Publication date: Available online 7 September 2018
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Peter J. Cvietusa, Glenn K. Goodrich, Jo Ann Shoup, David A. Steffen, Cathy Tacinas, Nicole M. Wagner, Courtney B. Anderson, Debra P. Ritzwoller, Bruce G. Bender
Association of Child Maltreatment with South African Adults’ Wages: Evidence from the Cape Area Panel Study
Child maltreatment is a prevalent public health problem in both developed and developing countries. While many studies have investigated the relationship between violence against children and health of the vic...
“The validity of the EQ-5D-5L in measuring quality of life benefits of breast reconstruction”
Publication date: Available online 6 September 2018
Source: Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Casimir A.E. Kouwenberg, Leonieke W. Kranenburg, Martijn S. Visser, Jan J. Busschbach, Marc A.M. Mureau
Summary
Background
The EuroQol EQ-5D-5L instrument is the most widely-used quality of life measure in health economic evaluations. It is unclear whether such a generic instrument is valid enough to estimate the benefits of breast reconstruction (BR), given the specific changes observed in quality of life after BR. Hence, we aimed to evaluate the validity of EQ-5D-5L in patients who had undergone postmastectomy BR.
Methods
In a 10-year cross-sectional cohort study, 463 mastectomy patients completed an online survey: 202 patients with autologous-BR (A-BR), 103 with implant-based-BR (I-BR), and 158 without BR (MAS). The results were used to evaluate the psychometric performance of EQ-5D-5L with respect to the ceiling effect and to known-group, convergent, and discriminant validity, by comparing it with the Breast-Q, the cancer-specific (EORTC-QLQ-C30), and breast cancer-specific (EORTC-QLQ-BR23) questionnaires.
Results
EQ-5D-5L was able to discriminate between patients with and without complications, MAS with or without BR and MAS versus the general population. It was, however, not able to discriminate between A-BR vs. I-BR as well as BR vs. general population. It is not clear whether this was due to the insensitivity of the instrument, insufficient sample sizes, or because there were no actual differences in QoL between these groups. Good convergent and discriminant validity of both EQ-5D-5L and its individual dimensions was demonstrated. Additional support for the instrument's validity was revealed by moderate correlations between the generic EQ-5D-5L and specific QoL aspects of BR such as sexuality and body image.
Conclusions
The results of this study support the validity of the EQ-5D-5L as an outcome measure in health economic evaluations of BR.
Effect of red light and near infrared laser on the generation of reactive oxygen species in primary dermal fibroblasts
Publication date: Available online 6 September 2018
Source: Journal of Photochemistry and Photobiology B: Biology
Author(s): Sajan George, Michael R. Hamblin, Heidi Abrahamse
Abstract
Irradiation with red light or near-infrared (NIR) lasers can bio-modulate cellular processes or revitalize injured tissues and therefore, widely been used for therapeutic interventions. Mechanistically, this cellular or biological process, referred as Photobiomodulation (PBM), is achieved by the generation of oxide free radicals in cells and tissues. This explorative study using red light (636 nm) and Near Infra-Red (NIR, 825 nm) laser at various irradiation exposures reckons the level of oxidative stress induced by these free radicals in human primary fibroblasts. Freshly isolated dermal fibroblasts were irradiated with red light and NIR at power densities of 74 and 104 mV/cm2, respectively and, at varying fluences ranging from 5 to 25 J/cm2. Cellular oxidative stress, measured by Reactive Oxygen Species (ROS) upon quantifying fluorescently labelled oxide free radicals in cells, detected considerable variations between the irradiation exposures of red light and NIR laser. The NIR laser demonstrated high levels of ROS at all fluences, except 10 J/cm2 indicating its ability in generating of two types of oxide radicals in dermal fibroblasts, often illustrated as biphasic response. Further, the responses of these cells to variable fluences of red light and NIR laser were measured to evaluate the immediate effect of PBM on cellular activity. The production of cellular energy coincides with the amount of oxidative stress, which was two-fold higher in cells irradiated with the NIR laser, as compared with the red light. This outcome indicates that the ROS production within biological systems are more dependent on the wavelength of the laser rather than its fluences. Further studies are required to avoid 'overdosing of PBM' and to analyse ROS qualitatively for making the best use of the red light and NIR laser in clinics.
Anthocyanic pigments from elicited in vitro grown shoot cultures of Vaccinium corymbosum L., cv. Brigitta Blue, as photosensitizer in natural dye-sensitized solar cells (NDSSC)
Publication date: Available online 6 September 2018
Source: Journal of Photochemistry and Photobiology B: Biology
Author(s): Simona Lucioli, Chiara Di Bari, Cinzia Forni, Aldo Di Carlo, Enrique Barrajón-Catalán, Vicente Micol, Paolo Nota, Federico Teoli, Fabio Matteocci, Andrea Frattarelli, Emilia Caboni
Abstract
We investigated the effect on anthocyanins and total phenols content and antioxidant capacity of in vitro shoot cultures of Vaccinium corymbosum L., cv. Brigitta Blue, grown on an eliciting medium supplied with 10 μM naphthalene acetic acid, in combination with reduced content of salts and organics in respect to the basal medium. After 45 days, higher content of total phenols and anthocyanins was obtained from extracts of shoots grown on the elicitation medium. Anthocyanin molecules, absent in control shoots, were identified by HPLC-MS as delphinidine-glycoside, cyanidine-glycoside, delphinidine-arabinoside, cyanidine- arabinoside and cyanidine-acetylglycoside. Chlorogenic acid, present in control shoots, was nearly absent in elicited shoots.
We exploited the anthocyanin - based raw extracts of "Brigitta Blue" shoots grown on the elicitation medium as a source of natural dye photosensitizers for Dye Sensitized Solar Cells, taking into account that such raw extracts showed antioxidant properties and photostability features. A purified dye was also prepared and the comparison of the latter with the raw one has been analysed by spectrophotometric, chromatographic and power conversion efficiency determination. The power conversion efficiencies from the raw and the purified dye were not different and they were comparable to the data obtained by other authors with anthocyanin-based dyes from in vivo grown plants.
Nécroses digitales révélant une maladie des agglutinines froides : traitement par rituximab
Publication date: Available online 7 September 2018
Source: Annales de Dermatologie et de Vénéréologie
Author(s): T. Klejtman, B. Garel, P. Senet, L. Tribout, C. Bachmeyer, A. Barbaud, J.-B. Monfort
Résumé
Introduction
Les nécroses des doigts sont rares en comparaison de celles des membres inférieurs. Elles sont une urgence médico-chirurgicale. Un bilan étiologique approfondi est indispensable. La maladie des agglutinines froides est une cause rare de nécroses digitales, de diagnostic difficile et souvent non recherchée.
Observation
Nous rapportons le cas d'un homme de 57 ans qui présentait un phénomène de Raynaud de la main gauche d'apparition récente, compliqué secondairement de nécroses digitales survenues après exposition professionnelle au froid (conducteur d'un chariot de manutention). Le bilan étiologique permettait de poser le diagnostic de maladie des agglutinines froides idiopathique. Un traitement par rituximab et des soins locaux ont permis une cicatrisation complète.
Discussion
La maladie des agglutinines froides est une cause rare d'anémie hémolytique auto-immune. Les signes cliniques cutanés, paroxystiques, déclenchés par le froid, sont au premier plan. Il existe une forme idiopathique et une forme secondaire à une hémopathie lymphoïde chronique, une maladie auto-immune ou une infection ; un bilan étiologique est indispensable. Le traitement qui permet d'obtenir le meilleur taux de réponse, associé à une bonne tolérance, est à ce jour le rituximab en perfusions hebdomadaires pendant 1 mois.
Summary
Background
Digital necrosis is rarer than lower limb necrosis and constitutes a medical or surgical emergency. Etiological evaluation is required. Cold agglutinin disease is a cause of digital necrosis but diagnosis is difficult.
Patients and methods
Herein we report the case of a 57-year-old man presenting recent paroxysmal acrosyndrome of the left hand subsequently complicated by digital necrosis following occupational exposure to cold in his work as a forklift driver. After etiological evaluation, a diagnosis of primary cold agglutinin disease was made. Intravenous rituximab and topical treatment resulted in complete healing.
Discussion
Cold agglutinin disease is a rare type of auto-immune hemolytic anemia. Following exposure to cold, paroxysmal cutaneous signs are frequent. The disease may be either primary or secondary with B-cell lymphoproliferative disorder, auto-immune disease or infection. A thorough workup is required. To date, the treatment combining the best positive response rate and good safety is rituximab in weekly perfusions over a 1-month period.
Efficacité spectaculaire de l’ivermectine topique dans un cas de granulome facial aseptique idiopathique
Publication date: Available online 6 September 2018
Source: Annales de Dermatologie et de Vénéréologie
Author(s): E. Blind, N. Ropars, G. Safa
Dermatitis alérgica de contacto al ácido kójico
Publication date: Available online 7 September 2018
Source: Actas Dermo-Sifiliográficas
Author(s): A. Tejera-Vaquerizo, J. García-Gavín
Tofacitinib for the Treatment of Alopecia Areata in Preadolescent Children
Publication date: Available online 6 September 2018
Source: Journal of the American Academy of Dermatology
Author(s): Brittany G. Craiglow, Brett A. King
Effective phytoremediation of low-level heavy metals by native macrophytes in a vanadium mining area, China
Abstract
Heavy metal contamination, particularly vanadium contamination in mining and smelting areas, is a worldwide serious problem threatening the ecological system and human health. The contamination level of vanadium, arsenic, cadmium, chromium, mercury, and lead in sediments and waters in a vanadium mining area in China was investigated in the present study. The behavior of heavy metal uptake by 12 native aquatic macrophytes was evaluated, including 5 species of emergent aquatic plants (Acorus calamus, Scirpus tabernaemontani, Typha orientalis, Phragmites australis, and Bermuda grass), 3 species of floating plants (Marsilea quadrifolia, Nymphaea tetragona, and Eleocharis plantagineiformis), and 4 species of submerged plants (Hydrilla verticillata, Ceratophyllum demersum, Myriophyllum verticillatum, and Potamogetom crispus). Different heavy metal accumulation abilities were found across these macrophytes. Generally, they tended to accumulate higher contents of chromium, and C. demersum showed a particularly higher accumulation capacity for vanadium. The heavy metals were preferentially distributed in roots, instead of translocation into leaves and stems, indicating an internal detoxification mechanism for heavy metal tolerance in macrophytes. In 24-day laboratory hydroponic experiments, the macrophytes had a satisfied phytoremediation performance for heavy metals, when their concentrations were at the microgram per liter level. Particularly, vanadium was effectively removed by P. australis and C. demersum, the removal efficiencies of which were approximately 50%. In addition, a combination of terrestrial plant (Bermuda grass) and aquatic macrophytes (P. australis, M. quadrifolia, and C. demersum) exhibited high uptake capacity of all the six heavy metals and their residual concentrations were 95 (vanadium), 39.5 (arsenic), 4.54 (cadmium), 17.2 (chromium), 0.028 (mercury), and 7.9 (lead) μg/L, respectively. This work is of significant importance for introducing native macrophytes to remove low-level heavy metal contamination, particularly vanadium, and suggests phytoremediation as a promising and cost-effective method for in situ remediation at mining sites.
Comparison of wounds’ infection rate between tap water and normal saline cleansing: A meta‐analysis of randomised control trials
International Wound Journal, EarlyView.
Type 1 Laryngeal Cleft and feeding and swallowing difficulties in infants and toddlers: A Review
Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.
Lateral and longitudinal variation in phosphorus fractions in surface sediment and adjacent riparian soil in the Three Gorges Reservoir, China
Abstract
Hydrological regimes have been significantly altered since the Three Gorges Dam (TGD) raised the water level of the reservoir to the maximum design level of 175 m in October 2010. This change might greatly influence the forms of phosphorus (P) in the sediment and the adjacent riparian soil. The purpose of this study was to reveal the lateral (sediment, water-level-fluctuation zone soil, and upland soil) and longitudinal (from the end of backwater area to the TGD) trends in P factions. Samples from 11 sites located along the main stem and ten sites located along eight tributaries were collected in June 2017. The P fractions were determined using the Standards, Measurements, and Testing (SMT) protocol. The results showed that the order of increase for average pH values was sediment (7.58 ± 0.62), WLFZ soil (7.44 ± 0.29), and adjacent upland soil (7.20 ± 0.68). The total organic carbon in the sediment was also highest with an average of 9.15 ± 2.97 mg·g−1. The average concentrated HCl-extractable P (total P), organic P (OP), inorganic P (IP), HCl-extractable P (HCl-P), and NaOH-extractable P (NaOH-P) were 630.02 ± 212.24, 161.89 ± 90.77, 468.13 ± 194.92, 335.65 ± 159.88, and 51.40 ± 36.20 mg·kg−1, respectively. The concentration of both total P and NaOH-P in the sediment of the main stem exhibited an increasing trend from the backwater area to the TGD. The average concentration of P species in the sediment was higher than those in the upland soil and the water-level-fluctuation zone (WLFZ) soil. For all the sediment and soil samples, the rank order of P species concentrations was HCl-P > OP > NaOH-P. Both IP and HCl-P were highly positively correlated with total P in the upland soil, the WLFZ soil and the sediment. However, only in the sediment, NaOH-P was positively correlated with total P and OP. All P species in the upland soil demonstrated greater spatial heterogeneity than those in the WLFZ soil and the sediment. Redundancy analysis revealed that the main variables explaining the variance in P species concentrations were Al in the upland soil and pH in the sediment.
“Over the Internet” sale of prescription‐level topical corticosteroids and dilemma of dermatologists
International Journal of Dermatology, EarlyView.
Activation of melanoblasts and melanocytes after treatment with monochromatic excimer light and narrowband‐ultraviolet B of skin of vitiligo patients
International Journal of Dermatology, EarlyView.
Correlation of clinical and pathologic evaluation of scarring alopecia
International Journal of Dermatology, EarlyView.
Issue Information
International Journal of Dermatology, Volume 57, Issue 10, Page i-iii,1147-1148, October 2018.
Pemphigus foliaceus induced by topical imiquimod treatment
International Journal of Dermatology, EarlyView.
Teaching and Learning Tips 12: Peer observation of teaching
International Journal of Dermatology, Volume 57, Issue 10, Page 1233-1236, October 2018.
Chronic granulomatous skin lesions leading to a diagnosis of TAP1 deficiency syndrome
Pediatric Dermatology, EarlyView.
A unique case of pressure‐induced alopecia following EEG monitoring
Pediatric Dermatology, EarlyView.
Management of a rare presentation of Kindler disease with digital constriction bands—Case report
Pediatric Dermatology, EarlyView.
Temporal trends in prenatal risk factors for the development of infantile hemangiomas
Pediatric Dermatology, EarlyView.
Subcutaneous fat necrosis of the newborn and associated hypercalcemia: A systematic review of the literature
Pediatric Dermatology, EarlyView.
Surgical treatment outcomes of infantile hemangioma in children: Does prior medical treatment matter
Pediatric Dermatology, EarlyView.
Cytomegalovirus ulcers following radiotherapy for a Marjolin ulcer in a renal transplant recipient
Australasian Journal of Dermatology, EarlyView.
Author Index 2018
Australasian Journal of Dermatology, Volume 59, Issue S2, Page 24-24, August 2018.
WCCS18 World Congress on Cancers of the Skin 2018 Sydney International Convention Centre 15‐18 August 2018
Australasian Journal of Dermatology, Volume 59, Issue S2, Page 3-23, August 2018.
Systemic treatments for alopecia areata: A systematic review
Australasian Journal of Dermatology, EarlyView.
Itching in a trichophytin contact dermatitis mouse model and the antipruritic effect of antifungal agents
Clinical and Experimental Dermatology, EarlyView.
Primary cicatricial alopecia in a single‐race Asian population: A 10‐year nationwide population‐based study in South Korea
The Journal of Dermatology, EarlyView.
Addition of oral mini pulse dexamethasone to NBUVB phototherapy and topical steroids helps arrest disease activity in patients with vitiligo
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
Local interventions for actinic keratosis in organ transplant recipients: A systematic review
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
Benefit‐risk of tofacitinib in patients with moderate to severe chronic plaque psoriasis: Pooled analysis across 6 clinical trials
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
A new clinical variant of acquired reactive perforating dermatosis‐like bullous pemphigoid
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
Πέμπτη 6 Σεπτεμβρίου 2018
Swedish translation and validation of the international skin tear advisory panel skin tear classification system
International Wound Journal, EarlyView.
Correction to: Facile synthesis of carbon-coated layered double hydroxide and its comparative characterisation with Zn–Al LDH: application on crystal violet and malachite green dye adsorption—isotherm, kinetics and Box-Behnken design
The original publication of this paper contains an error. The correct Figure 8 is shown in this paper.
Synthesis of mesoporous core-shell TiO 2 microstructures with coexposed {001}/{101} facets: enhanced intrinsic photocatalytic performance
Abstract
TiO2 microstructures were synthesized via a facile one-step route for enhanced intrinsic photocatalytic performance. The prepared TiO2 microstructures are featured by both mesoporous core-shell structures and coexposed {001}/{101} facets. Their intrinsic photocatalytic performance were remarkably enhanced due to their high specific surface area, coexposed {001}/{101} facets, and promoted separation of photogenerated carriers. Furthermore, the origin and detailed mechanism for diethylenetriamine (DETA) that served as a high efficient stabilizer of TiO2 {001} facet have been theoretically investigated. Finally, a new DETA-modified Ostwald ripening mechanism was originally proposed when studying the growth mechanism of the mesoporous core-shell TiO2 spherical microstructures with coexposed {001}/{101} facets.
Predicting Genotype and Survival in Glioma Using Standard Clinical MR Imaging Apparent Diffusion Coefficient Images: A Pilot Study from The Cancer Genome Atlas [ADULT BRAIN]
BACKGROUND AND PURPOSE:
Few studies have shown MR imaging features and ADC correlating with molecular markers and survival in patients with glioma. Our purpose was to correlate MR imaging features and ADC with molecular subtyping and survival in adult diffuse gliomas.
MATERIALS AND METHODS:Presurgical MRIs and ADC maps of 131 patients with diffuse gliomas and available molecular and survival data from The Cancer Genome Atlas were reviewed. MR imaging features, ADC (obtained by ROIs within the lowest ADC area), and mean relative ADC values were evaluated to predict isocitrate dehydrogenase (IDH) mutation, 1p/19q codeletion status, MGMT promoter methylation, and overall survival.
RESULTS:IDH wild-type gliomas tended to exhibit enhancement, necrosis, and edema; >50% enhancing area (P < .001); absence of a cystic area (P = .013); and lower mean relative ADC (median, 1.1 versus 1.6; P < .001) than IDH-mutant gliomas. By means of a cutoff value of 1.08 for mean relative ADC, IDH-mutant and IDH wild-type gliomas with lower mean relative ADC (<1.08) had poorer survival than those with higher mean relative ADC (median survival time, 24.2 months; 95% CI, 0.0–54.9 months versus 62.0 months; P = .003; and median survival time, 10.4 months; 95% CI, 4.4–16.4 months versus 17.7 months; 95% CI, 11.6–23.7 months; P = .041, respectively), regardless of World Health Organization grade. Median survival of those with IDH-mutant glioma with low mean relative ADC was not significantly different from that in those with IDH wild-type glioma. Other MR imaging features were not statistically significant predictors of survival.
CONCLUSIONS:IDH wild-type glioma showed lower ADC values, which also correlated with poor survival in both IDH-mutant and IDH wild-type gliomas, irrespective of histologic grade. A subgroup with IDH-mutant gliomas with lower ADC had dismal survival similar to that of those with IDH wild-type gliomas.
Near-Term Decrease in Brain Volume following Mild Traumatic Injury Is Detectible in the Context of Preinjury Volumetric Stability: Neurobiologic Insights from Analysis of Historical Imaging Examinations [ADULT BRAIN]
BACKGROUND AND PURPOSE:
Neurodegeneration after mild traumatic brain injury may manifest as decreasing regional brain volume that evolves from months to years following mild traumatic brain injury and is associated with worse clinical outcomes. We hypothesized that quantitative brain volume derived from CT of the head, performed for clinical indications during routine care, would change with time and provide insights into the putative neuroinflammatory response to mild traumatic brain injury.
MATERIALS AND METHODS:We searched the electronic medical record of our institution for NCCTs of the head performed in patients with mild traumatic brain injury and included those who also underwent NCCTs of the head 1 month to 1 year before and after mild traumatic brain injury for an indication unrelated to trauma. Controls underwent 3 sequential NCCTs of the head with indications unrelated to trauma. The whole-brain and intracranial volume groups were computed using ITK-SNAP. Brain volumes normalized to intracranial volumes were compared across time points using the Wilcoxon signed-rank test.
RESULTS:We identified 48 patients from 2005 to 2015 who underwent NCCTs of the head in the emergency department for mild traumatic brain injury and had NCCTs of the head performed both before and after mild traumatic brain injury. Median normalized brain volumes significantly decreased on the follow-up study post-mild traumatic brain injury (0.86 versus 0.84, P < .001) and were similar compared with pre-mild traumatic brain injury studies (0.87 versus 0.86, P = .927). There was no significant difference between normalized brain volumes in the 48 controls.
CONCLUSIONS:A decrease in brain volume following mild traumatic brain injury is detectable on CT and is not seen in similar patients with non-mild traumatic brain injury during a similar timeframe. Given the stability of brain volume before mild traumatic brain injury, CT volume loss may represent the subtle effects of neurodegeneration.
Apparent Diffusion Coefficient Levels and Neurodevelopmental Outcome in Fetuses with Brain MR Imaging White Matter Hyperintense Signal [PEDIATRICS]
BACKGROUND AND PURPOSE:
One of the perplexing findings of fetal brain MR imaging is white matter T2 hyperintense signal. The aims of our study were initially to determine the main etiologies associated with white matter T2 hyperintense signal, then to examine whether the different etiologies have different ADC values, and, last, to assess the association of white matter T2 hyperintense signal with developmental outcome.
MATERIALS AND METHODS:This was a prospective cohort study of 44 MR imaging scans of fetal brains obtained for suspected brain pathologies at a tertiary medical center during 2011–2015. Clinical data were collected from electronic medical charts. ADC values were measured and averaged in the frontal, parietal, occipital, and temporal lobes. Neurodevelopmental assessments were performed with the Vineland Adaptive Behavior Scales II.
RESULTS:Half of the cases of MRI hyperintense T2 signal of the fetal brain were associated with congenital cytomegalovirus infection. The other half were mainly idiopathic. Thus, the study group was divided to subgroups positive and negative for cytomegalovirus. Both groups had hyperintense signal in the temporal lobe. The group positive for cytomegalovirus had involvement of the parietal lobe. Only this group had increased ADC values in the temporal and parietal lobes. There was no association between the neurodevelopment outcome and the etiologies or ADC values.
CONCLUSIONS:T2 hyperintense signal in fetal brain MRI associated with positive cytomegalovirus infection has increased ADC values in the temporal and parietal lobes, suggestive of brain edema in these areas. However, the association between this finding and neurodevelopment outcome requires further evaluation.
“The validity of the EQ-5D-5L in measuring quality of life benefits of breast reconstruction”
The EuroQol EQ-5D-5L instrument is the most widely-used quality of life measure in health economic evaluations. It is unclear whether such a generic instrument is valid enough to estimate the benefits of breast reconstruction (BR), given the specific changes observed in quality of life after BR. Hence, we aimed to evaluate the validity of EQ-5D-5L in patients who had undergone postmastectomy BR.
Previously undiagnosed Darier disease complicated by bilateral ecthyma gangrenosum masquerading as a vasculopathy with retiform eschar formation
We present the case of a 57-year-old incarcerated man with a history of hepatitis C and life-long presumed atopic dermatitis who presented with a two month history of painful, progressive, ulcerations with overlying eschars on his bilateral lower extremities. He had been treated unsuccessfully with oral trimethoprim-sulfamethoxazole and clindamycin before admission. Upon admission, he was found to have leukocytosis but was otherwise hemodynamically stable and afebrile. On exam, he had erythematous hyperkeratotic papules coalescing into plaques on the neck, chest, abdomen, back, and extremities, with a flexural predominance, and retiform ulcerations with overlying eschars on the bilateral lower legs.
Onychogryphosis: A case report and review of the literature
Patient history: A 67-year-old man presented with a 30-year history of severe thickening, curving, and yellow discoloration of his left great toenail. He stated that the nail broke off midway and regrew every six months. It had become more painful recently and was impinging on his second toe, making it difficult to walk and put on socks. There is no history of trauma, tinea pedis or family history of onychomycosis. Physical examination was notable for thickening and lateral deviation of the left first toenail.
Peristomal pyoderma gangrenosum in a patient with chronic ulcerative colitis: Case report
Introduction: Peristomal pyoderma gangrenosum (PPG) is a rare subtype of pyoderma gangrenosum that could be difficult to diagnose and treat. A painful necrotic ulcer surrounding an area of abdominal stoma with rapidly progression is the clinical hallmark. It is almost exclusively associated with inflammatory bowel disease (IBD). In this report, we present a 63-year-old man previously diagnosed of chronic ulcerative colitis (CUC) that develop a peristomal pyoderma gangrenosum 2 years after surgery.
Necrotisans erythema nodosum leprosum with systemic manifestations
Introduction: Erythema nodosum leprosum (ENL) is an acute reaction that generally occurs during the treatment of multibacillary leprosy. Severe cases can lead to necrotic ulcers and cause extra cutaneous manifestations. One case of necrotisans erythema nodosum leprosum (NENL) is reported to show that leprosy late diagnosis and treatment can cause severe cutaneous and systemic manifestations.
Pruritus in patients under targeted anticancer therapy: Multidimensional analysis using the 5-D itch scale
Background: Pruritus is very common symptom in patients under anticancer therapy. However, the characteristics of pruritus according to anticancer agents have not been known well.
Platelet-rich plasma for skin rejuvenation: A systematic review of the clinical evidence
Background: Recently, platelet-rich plasma (PRP) has been used as an off-label treatment for a variety of clinical conditions including skin rejuvenation (SR). The effectiveness of PRP for SR is unclear due to lack of standardization for PRP administration. We aimed to assess the level of evidence (LOE) for safety and efficacy of PRP for SR.
Patient experience of the “two-week wait” cancer referral pathway in a large secondary care department in England
Background: The 2-week wait (2WW) system has been implemented across the NHS in England to enable rapid referral of patients with squamous cell carcinoma and malignant melanoma from primary to secondary care. Patients are told that the referral is to exclude skin cancer. In our secondary care dermatology department, a 2-week lag between referral and dermatology consultation represents a 19-week reduction in wait time (WT) from a standard referral. Little is currently known about the patients' perception of this streamlining, how WT impacts patient quality of life, and how appropriate patients consider this WT when being referred for suspected malignancy.
Nonmelanoma skin cancer in HIV-positive patients: A six-year single-institution retrospective review
Background: HIV-positive (HIV+) patients have been demonstrated to have an increased incidence of nonmelanoma skin cancer (NMSC) at 2.1-2.8 times the rate found in HIV negative (HIV-) populations. Rates of NMSC with aggressive subclinical extension (ASE), defined as extensive subclinical tumor spread revealed during Mohs micrographic surgery (MMS), have not been found to be significantly different in HIV+ and HIV− populations in a previous study. However, HIV disease progression (CD4 and CD8 levels and viral load) and NMSC characteristics and their relationship to presence of NMSC with ASE within the HIV+ population remain unclear.
Process of standardized postoperative telephone follow-up implementation for Mohs micrographic surgery
Mohs micrographic surgery (MMS) is an effective outpatient procedure for skin cancer removal with low reported complication rates. Identifying both major and minor postoperative complications is necessary to improve the quality of Mohs-based surgical care. There are currently no established standards for regular patient follow-up after MMS. Therefore, there exists a need to determine standardized, cost-effective, and reproducible follow-up strategies. The objective of this study was to determine whether routine telephone follow-up is an effective tool to capture postoperative complications and other patient-reported concerns.
Predicting therapy outcome by HLA-Cw6 genotyping in psoriasis patients treated with secukinumab
Introduction: A possible correlation of genetic markers and response to treatment has been proclaimed. The strongest association has been shown between HLA-Cw6 and ustekinumab. So far it is unclear whether this effect can be also found in IL-17.
Pigmented eccrine poroma: A clinical dermoscopy challenge
Eccrine poroma is a benign neoplasia originated from the intraepidermal portion of the sweat gland duct. It is characterized by a papule, plaque or nodule, normochromic or erythematous, exophytic or hyperkeratotic. Although its pathogenesis is still unknown, it seems to be related to radiation, trauma or scars. The pigmented variant, more frequent in blacks and affecting mainly nonacral areas, is responsible for 17% of the cases. Various clinical-dermatoscopic features have been described, directing its differential diagnosis to other benign and malignant neoplasia, such as seborrheic keratosis, epithelized pyogenic granuloma, basal-cell and squamous-cell carcinoma, angiofibroma, and melanoma.
Pediatric melanoma immunotherapy: A retrospective examination of a decade of clinical experience at a tertiary care center
Background: Pediatric or adolescent melanoma, defined as melanoma in patients below age 20, is an infrequent occurrence that represents 0.4% of the approximately 87,110 new cases of melanoma diagnosed in the United States annually. As a result, few data exist to guide therapy that prolong survival, in particular with more recently developed immune therapies, such as immune checkpoint inhibitors. This lack of data is especially important as there is growing evidence that pediatric melanoma differs in its presentation, gene expression, and behavior from adult melanoma, and that response to therapy may vary by age.
Painful subcutaneous lesions in a patient with metastatic melanoma
Introduction: We present the case of a patient with metastatic melanoma (MM) treated with combined therapy (vemurafenib + cobimetinib), who develops painful subcutaneous lesions compatible with secondary panniculitis.
Old is gold—Revisiting the efficacy of topical psoralen–ultraviolet A phototherapy for palmoplantar dermatoses
Palmoplantar involvement of dermatoses such as atopic dermatitis and psoriasis has significant impact on quality of life. While systemic treatment options have increased in recent years, topical psoralen ultraviolet A (tPUVA) therapy remains a viable option when topical treatments have failed and potential systemic adverse events outweigh benefits. Literature on tPUVA efficacy is sparse. Our objectives were to report the efficacy of tPUVA after an initial treatment course and to identify associated clinical factors.
Nicolau syndrome appears after filling hyaluronic acid with the use of blanching technique
A 34-year-old woman was treated in our clinic for mild acne and scars. Two years before, oral isotretinoin was given to the patient with a complete healing of the acne but numerous 2–3-mm scars remained in both cheeks. Two sessions of a nonablative CO2 laser was performed one year after the termination of the isotretinoin treatment with partial improvement of the scars. After that, a blanching technique with hyaluronic acid was offered to the patient. She was injected with a low reticulated hyaluronic acid with lidocaine using a 30 Gy needle doing a blanching technique to fill the scars presented in her cheeks.
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A Case of Diprosopus Tetraophthalmos: Ocular Findings and Surgical Treatment of Exposure KeratopathyDiprosopus is a rare variation of conjoined twinning. In this report, ophthalmic findings in an infant with diprosopus tetraophthalmos are p...
