Comparison between the efficacy of microneedling combined with 5-fluorouracil vs microneedling with tacrolimus in the treatment of vitiligo

Summary

Background

Several treatment modalities had been used for the treatment of vitiligo, but the optimal treatment has not yet been identified.

Objectives

To study the efficacy of microneedling with 5-flurouracil vs its efficacy with tacrolimus in the treatment of vitiligo.

Patients and methods

Twenty-five patients with vitiligo were subjected to microneedling of 2 patches of vitiligo with dermapen, then application of 5-fluorouracil to 1 patch and tacrolimus on the other patch. This procedure was repeated every 2 weeks for every patient for maximum 6 months (12 sessions). The patients were followed up for 3 months after the last session.

Results

The overall repigmentation was significantly higher in 5-fluorouracil-treated patches compared with tacrolimus. Excellent improvement occurred in 48% of 5- flurouracil-treated patches while only in 16% of tacrolimus-treated patches. In the acral parts, 40% of the patches treated with 5-fluorouracil achieved excellent improvement (repigmentation >75%), while no patch in the acral parts achieved excellent improvement with tacrolimus. However, there was significant difference between the 2 drugs,regarding inflammation, ulceration, and hyperpigmentation which occurred with 5-fluorouracil.

Conclusion

Microneedling combined with 5-fluorouracil or tacrolimus is safe and effective treatment of vitiligo. However, 5-fluorouracil achieved a greater percentage of repigmentation than tacrolimus particularly in the acral parts.

Justifying the principle of indifference

Abstract

This paper presents a new argument for the Principle of Indifference. This argument can be thought of in two ways: as a pragmatic argument, justifying the principle as needing to hold if one is to minimise worst-case expected loss, or as an epistemic argument, justifying the principle as needing to hold in order to minimise worst-case expected inaccuracy. The question arises as to which interpretation is preferable. I show that the epistemic argument contradicts Evidentialism and suggest that the relative plausibility of Evidentialism provides grounds to prefer the pragmatic interpretation. If this is right, it extends to a general preference for pragmatic arguments for the Principle of Indifference, and also to a general preference for pragmatic arguments for other norms of Bayesian epistemology.

Demodex mites modulate sebocyte immune reaction: Possible role in the pathogenesis of rosacea

Abstract

Rosacea is a common facial skin disorder affecting middle-aged adults. Its aetiology is unknown and pathogenesis uncertain. Activation of the host innate immune response has been identified as important. The Demodex mite population in the skin of these patients is significantly higher than in subjects with normal skin suggesting they may be of etiological importance in this disorder. Little is known of the role of these mites in human skin and their potential to interact with the host immune system has not been elucidated.

Live Demodex mites were extracted from normal facial skin of control subjects and used in cell stimulation experiments with the immortalised SZ95 sebocyte line. Time and mite dose dependent experiments were performed. Direct Demodex effects and the effects of medium in which Demodex had been cultured were evaluated on the TLR-signalling pathway on both a gene and protein expression level.

Mites modulated TLR signalling events on both mRNA and protein levels in SZ95 sebocytes. An initial trend towards down modulation of genes in this pathway was observed. A subsequent switch to positive gene up-regulation was recorded after 48 hours of co-culture. Demodex secreted bioactive molecules that affected TLR2 receptor expression by sebocytes. High numbers of Demodex induced pro-inflammatory cytokine secretion whereas lower numbers did not.

Demodex mites have the capacity to modulate the TLR signalling pathway of an immortalised human sebocyte line. Mites have the capacity to secrete bioactive molecules that affect the immune reactivity of sebocytes. Increasing mite numbers influenced IL8 secretion by these cells.

This article is protected by copyright. All rights reserved.

Unilateral Cleft Lip Rhinoplasty

Cleft lip rhinoplasty is a challenging procedure both in terms of obtaining desirable appearance and function, but also in achieving consistency across one's patient population. Classically, formal nasal surgery was delayed until the patient had completed nasal and mid-facial growth, however, this paradigm is changing, and more rhinoplasty is being performed at the time of the lip repair which has revolutionized patient outcomes. The three options for repair in terms of timing are designated as primary, intermediate, and secondary (defined later in this text).

Toxic effect and mechanism of four ionic liquids on seedling taproots of Arabidopsis thaliana

Abstract

Arabidopsis thaliana was selected as model organisms to investigate the toxic effect and mechanism of four kinds of imidazolium and pyridinium ionic liquids (ILs) on plant seedling taproots. After exposure to ILs, the growth of seedling taproots was significantly inhibited in a dose-dependent manner. The toxicity of ILs on seedling taproots was [Bmim][BF₄] > [Bmpy][BF₄] > [Bmim][Br] > [Bmpy][Br]. The reduction of seedling root cell vitality, aggravation of seedling root cell death, and repression of gravitropic growth responses were observed. The amounts of H₂O₂ and ROS in seedlings were enhanced with increasing concentrations of ILs. Moreover, the expression levels of cdc2a and pcna1 genes were decreased after exposure to ILs. Our results suggest that ILs can induce the overproduction of ROS in A. thaliana seedling taproots and thus cause oxidative damage to seedling taproots. Meanwhile, ILs alter the expression patterns of two cell cycle-related genes and hence cause the seedling taproot growth inhibition. This work provides an integrated understanding of the toxic effect and mechanism of ILs on A. thaliana seedlings at the molecular and physiological level and also provides theoretical basis and reference for the environmental safety evaluation of ILs, prior to their widespread use and release.

Graphical abstract

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Bioimpedance measurement as an assessment of margin positivity in Mohs surgical specimens of non-melanoma skin cancer: Management implications

High neutrophil-to-lymphocyte ratio before starting anti-PD1 immunotherapy predicts poor outcome in patients with metastatic melanoma

Increased Topical Generic Prices by Manufacturers: An Isolated Trend or Worrisome Future?

There is limited data regarding generic medication prices. Recent studies have shown price changes at the retail level, but much is not known about the pharmaceutical supply chain or price changes at the manufacturer level.

Clinical, dermoscopic and trichoscopic analysis of frontal fibrosing alopecia associated with acquired dermal macular hyperpigmentation: A cross sectional observational case-control study

Studies on mercury occurrence in inorganic constituents of Polish coking coals

Abstract

During the cokemaking process, a significant amount of mercury occurring in a coal blend is released to the atmosphere. One of the ways of reducing this emission is to reduce mercury content in a coal blend. This could be obtained through the coal washing process. The optimization of this process requires the knowledge of mercury occurrence in coal, especially in its inorganic constituents. A qualitative analysis of mercury occurrence in the inorganic constituents of Polish coking coals was performed using an electron probe microanalyzer (EPMA). For that purpose, selected samples of rejects and middling products derived from the washing process in dense media separators and jig concentrators were examined. The obtained results have confirmed a strong connection between mercury occurrence and the presence of sulfides (pyrite, marcasite, and chalcopyrite) in Polish coking coals. Significant amounts of mercury were also noticed for barite, siderite, and aluminosilicates. The highest value of mercury content, at the level of 0.100%, was obtained for marcasite. For the analyzed coals, the effectiveness of mercury removal in the washing process was determined by the forms of pyrite occurring in coal. The highest values of effectiveness of mercury removal were obtained in the case of coals for which the large framboidal pyrite aggregates with chalcopyrite overgrowths were noticed. It was also found that middling products were characterized by the occurrence of the Hg-rich overgrowths of pyrite on organic matter. To achieve a significant reduction in mercury content in clean coal, it is necessary to develop an effective method of removing this form of pyrite from hard coal.

Characterization of phosphate rock and phosphogypsum from Gabes phosphate fertilizer factories (SE Tunisia): high mining potential and implications for environmental protection

Abstract

Since the establishment of the coastal industrial complex in Gabes city (Gulf of Gabes, SE Tunisia), hundred million tons of untreated phosphogypsum have been discharged in the open sea causing serious environmental problems. To better understand the dynamic and behavior of phosphate/phosphogypsum contaminants from raw ores to marine environment, a chemical, organic, mineralogical, and morphological characterization of phosphate rock and phosphogypsum was conducted using several sophisticated techniques. The chemical analysis showed that phosphate and phosphogypsum contain high loads of trace elements and that the transfer factors of pollutants varied from 5.83% (U) to 140% (Hg). Estimated annual flows of phosphogypsum contaminants into the marine environment ranged between 0.05 (Re) and 87,249.60 (F) tons. The phosphate rock was found to be formed by carbonate fluorapatite, calcite, dolomite, natural gypsum, quartz, calcite-Mg, apatite, pyrite, fluorite, and sphalerite-Cd and phosphogypsum by synthetic gypsum and sphalerite-Cd. The phosphate was found to be richer in organic compounds compared to phosphogypsum. Based on this work, the Tunisian phosphogypsum has a high mining potential and encourages the development of an economically beneficial and environmentally friendly phosphogypsum-treating industry.

Modeling the emissions of a dual fuel engine coupled with a biomass gasifier—supplementing the Wiebe function

Abstract

There is a growing market demand for small-scale biomass gasifiers that is driven by the economic incentives and the legislative framework. Small-scale gasifiers produce a gaseous fuel, commonly referred to as producer gas, with relatively low heating value. Thus, the most common energy conversion systems that are coupled with small-scale gasifiers are internal combustion engines. In order to increase the electrical efficiency, the operators choose dual fuel engines and mix the producer gas with diesel. The Wiebe function has been a valuable tool for assessing the efficiency of dual fuel internal combustion engines. This study introduces a thermodynamic model that works in parallel with the Wiebe function and calculates the emissions of the engines. This "vis-à-vis" approach takes into consideration the actual conditions inside the cylinders—as they are returned by the Wiebe function—and calculates the final thermodynamic equilibrium of the flue gases mixture. This approach aims to enhance the operation of the dual fuel internal combustion engines by identifying the optimal operating conditions and—at the same time—advance pollution control and minimize the environmental impact.

Successfully Managing Impending Skin Necrosis following Hyaluronic Acid Filler Injection, using High-Dose Pulsed Hyaluronidase

Summary: Facial fillers are becoming increasingly popular as aesthetic procedures to temporarily reduce the depth of wrinkles or to contour faces. However, even in the hands of very experienced injectors, there is always a small possibility of vascular complications like intra-arterial injection of filler substance. We present a case report of a patient who developed features of vascular obstruction in right infraorbital artery and tell-tale signs of impending skin necrosis, after hyaluronic acid filler injection by an experienced injector. The diagnosis of a vascular complication was made quickly with the help of clinical features like blanching, livedo reticularis, and poor capillary refill. Patient was treated promptly with "high-dose pulsed hyaluronidase protocol" comprising three 1,000-unit pulses of hyaluronidase, administered hourly. There was no further increase in size of the involved area after the first dose of hyaluronidase. All of the involved area, along with 1 cm overlapping in uninvolved skin area, was injected during each injection pulse, using a combination of cannula and needle. Complete reperfusion and good capillary filling were achieved after completion of 3 pulses, and these were taken as the end-point of high-dose pulsed hyaluronidase treatment. Immediate skin changes after filler injections, as well as after hyaluronidase injections and during the 3-week recovery period, were documented with photographs and clinical notes. Involved skin was found to have been fully recovered from this vascular episode, thus indicating that complete recovery of the ischemic skin changes secondary to possible intra-arterial injection could be achieved using high-dose pulsed hyaluronidase protocol.

Minimally Invasive Face Lifting and Lipofilling

No abstract available

In vivo validation of the multicomponent powder (Vitachelox®) against the deposition of polluting ions

What are we measuring? Refocusing on some fundamentals in the age of desktop bibliometrics

BibliometricsResearch evaluationConstruct validity

Treatment of inflammatory bowel disease via green tea polyphenols: possible application and protective approaches

Abstract

Inflammatory bowel disease (IBD) is a collection of inflammatory conditions of colon and small intestine which affect millions of individuals worldwide and the prevalence amount is on the rise. The organ failure as well as loss of tissue function is because of the inflammatory reaction which is the major contributor of tissue healing leading to lifelong debilitation. To stop the tough consequences of inflammation every patient pursues alternative therapy to relieve symptoms. Green tea polyphenols (GTPs) play significant roles in down regulating signaling pathways because GTPs exert effective antioxidant properties and regulate Toll-like receptor 4 (TLR4) expression via certain receptor, inhibited endotoxin-mediated tumor necrosis factor alpha (TNF-α) production by blocking transcription nuclear factor-kappa B (NF-kB) activation and upstream of mediated I kappa B kinase complex pathway activities, as well as intrusion with the flow of cytokines and synthesis of cyclooxygenase-2 (COX-2). This article highlights the green approach regarding the defensive effects of GTP review-related studies concerning the contrary effects and the key therapeutic targets application of GTPs in biomedical field to treat inflammatory bowel disease (IBD) and its complications.

Graphical abstract

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Predicting methotrexate resistance in rheumatoid arthritis patients

Abstract

Rheumatoid arthritis (RA) is an incurable, systemic autoimmune disease that decreases quality of life and can lead to severe disability. While there are many medications available to treat RA, the first-line of therapy is low-dose methotrexate (MTX), a small molecule disease-modifying anti-rheumatic drug (DMARD). MTX is the recommended therapy due to its affordability and efficacy in reducing symptoms in most RA patients. Unfortunately, there is great person-to-person variability in the physiological response to MTX, with up to 50% of patients showing little response to the medication. Thus, many RA patients initially placed on MTX do not experience an adequate reduction of symptoms, and could have benefited more in both the short and long terms if initially prescribed a different drug that was more effective for them. To combat this problem and better guide treatment decisions, many research groups have attempted to develop predictive tools for MTX response. Currently, there is no reliable, clinical-grade method to predict an individual's response to MTX treatment. In this review, we describe progress made in the area of MTX non-response/resistance in RA patients. We specifically focus on application of the following elements as predictive markers: proteins related to MTX transport and function, intracellular MTX concentration, immune cell frequencies, cytokines, and clinical factors.

Correction to: Anti-inflammatory, anti-rheumatic and analgesic activities of 2-(5-mercapto-1,3,4-oxadiazol-2-yl)- N -propylbenzenesulphonamide (MOPBS) in rodents

Abstract

Unfortunately, Fig. 1 was incorrectly published in the original publication. The corrected Fig. 1 is given as below

The tissue distribution and excretion study of paeoniflorin-6′-O-benzene sulfonate (CP-25) in rats

Abstract

Paeoniflorin-6′-O-benzene sulfonate (code: CP-25) is a novel ester derivative of paeoniflorin (Pae). Compared to Pae, CP-25 has higher lipid solubility, bioavailability and better bioactivity. However, the tissue distribution and excretion of CP-25 still remain unknown. The LC–MS method was applied to investigate the tissue distribution and excretion of CP-25 in rats. As such, 50 mg/kg of CP-25 and Pae were administered to rats in multiple doses via an oral route. CP-25 and Pae were distributed widely and rapidly in all the tested tissues. Compared with Pae, the concentrations of CP-25 were almost increased evidently in most tissues. The highest CP-25 level was found in the liver (1476.33 ± 535.20 ng/g, male; 1970.38 ± 177.21 ng/g, female) at 3 h, and a high concentration of CP-25 was detected in male and female intestine, synovium, muscle, lung, and brain. Following a single oral dose of 50 mg/kg of CP-25 in rats, the total excretion of CP-25 was merely 21.8% (18.40, 3.19 and 0.22% for feces, bile and urine, respectively) in males; and was approximately 21.3% (14.04, 7.16 and 0.14% for feces, bile and urine, respectively) in females. The results indicated that the CP-25 concentration was higher in major tissues than Pae; CP-25 was primarily excreted through the feces; and there were gender-related differences in the tissue distribution and excretion.