Treatment of severe atopic dermatitis with tralokinumab in clinical practice: short-term effectiveness and safety results.

BACKGROUND: Tralokinumab was recently approved for the treatment of moderate-to-severe atopic dermatitis (AD) and is the first selective interleukin (IL)-13 inhibitor that specifically neutralizes IL-13 with high affinity. OBJECTIVES: To determine the real-life short-term effectiveness and safety of tralokinumab treatment in patients with moderate-to-severe AD. METHODS: A multicentre retrospective study was conducted including adult patients with moderate-to-severe AD who started tralokinumab treatment from 1 April to 30 June 2022 in 16 Spanish hospitals. Demographic and disease characteristics, severity and quality of life scales were collected at the baseline visit and at weeks 4 and 16. RESULTS: Eighty-five patients were included. Twenty-seven patients (32%) were non-naive to advanced therapy (biological or Janus kinase inhibitors inhibitors). All included patients had severe disease with baseline Eczema Area and Severity Index (EASI) scores of 25.4 (SD 8.1), Dermatology Life Quality Index (DLQI) 15.8 (5.4) and peak pruritus numerical rating scale (PP-NRS) 8.1 (1.8) and 65% had an Investigator's Global Assessment (IGA) of 4. At week 16, there was improvement on all scales. The mean EASI decreased to 7.5 (SD 6.9, 70% improvement), SCORing Atopic Dermatitis improved 64% and PP-NRS, 57%. Also, 82%, 58% and 21% of the patients achieved EASI 50, 75 and 90, respectively. The percentage of EASI 75 responders was significantly higher among the naive vs. non-naive groups (67% vs. 41%). The safety profile was acceptable. CONCLUSIONS: Patients, with a long history of disease and prior multidrug failure, showed a good response to tralokinumab, confirming clinical trial results.

Masking ability of resin composites: A scoping review.

OBJECTIVE: To map the existing evidence regarding the masking ability of resin composites. OVERVIEW: The literature search was conducted electronically, based on the PRISMA Extension for Scoping Reviews-online protocol at https://osf.io/m2h67/ with no language or time restrictions. Two independent reviewers conducted the screening, and a third reviewer was consulted in case of disagreement. Studies that evaluated resin composite masking ability regardless of background, application technique, thickness, or number of layers were selected. The search found 2995 potentially eligible studies. After removal of duplicates (657), irrelevant articles (2323), 15 citations met the eligibility criteria based on title and abstract, and eight studies were included based on full text analysis (seven in vitro, and one case report). Acceptable masking ability is obtained by one layer of opaque shade resin composite or by the layering technique. A black background is masked with 1.0- to 2.0 mm-thick layers of opaque shade resin composites. Masking of the C4 background is achieved with one layer of 0.5- to 1.5 mm-thick opaque shade resin composite or by the layering technique using different combinations of enamel body and dentin shades with a final thickness of 1.5 mm. CONCLUSIONS: Acceptable masking of C4 shade background is achieved with one layer of opaque shade composite at least 0.5 mm-thick or by different combinations of the layering technique, with a final thickness of 1.5 mm. Acceptable masking of the black background of the oral cavity is achieved with a resin composite of at least 1.0 mm opaque shade. CLINICAL SIGNIFICANCE: The thickness of the resin composite layer required to achieve adequate masking is variable and depends on the translucency/opacity of the tested resin composites and the background shade.

Effect of layering strategy and prolonged water aging on masking ability of composite resins.

STATEMENT OF PROBLEM: Layered composite resins may adequately mask discolored substrates. However, whether color changes that occur over time affect masking ability is unclear. PURPOSE: The purpose of this in vitro study was to investigate the effect of layering and water aging on the masking ability of 2 composite resins. MATERIAL AND METHODS: Disk specimens (1.5 mm-thick and shade A1) from Charisma Diamond (CD) and Filtek Z350XT (Z350) were made according to the composite resin shade combination used in the layering strategies: bilayer for CD (enamel/dentin) and for Z350 (enamel/body and enamel/dentin) and trilayer for Z350 (enamel/body/dentin) (n=5). Color measurements were obtained with a spectrophotometer over an A3.5 ceramic substrate, and the whiteness index for dentistry (WID) was calculated. The specimens were aged in water at 37 °C and evaluated at different times: 24 hours, 1 week, 1 month, 2 months, 6 months, 12 months, 18 months, and 24 months. CIEDE2000 color differences (ΔE00) and WID differences (ΔWID) were calculated and interpreted by 50:50% color and whiteness perceptibility and acceptability thresholds. Changes among strategies and aging times were analyzed using the Kruskal-Wallis test (α=.05). Contrasts were made using the Mann-Whitney U test with Bonferroni correction (α=.001). RESULTS: ΔE00 decreased from 24 hours to 2 months of aging. From 2 months onwards, ΔE00 increased for all layering strategies and times, without significant changes in lightness for CD (P>.004). Overall, for the CD restorative system, an increase in ΔWID was observed after 1 month of aging (P<.001), while for the Z350 restorative system, ΔWID decreased after aging (P<.001), except for the Z350 bilayer strategy (enamel + dentin) at 1 week and 2 months (P>.004). For all layering strategies and aging times, color differences were higher than the 50:50% perceptibility threshold for ΔE00 and, after 6 months, higher than the 50:50% acceptability threshold for ΔE00 and the 50:50% whiteness acceptability threshold. CONCLUSIONS: The ability of the tested composite resins to mask a discolored substrate was affected by the layering approach applied and by prolonged water aging.

Effectiveness and color stability of bleaching techniques on blood-stained teeth: An in vitro study.

OBJECTIVE: Evaluate the effectiveness and color stability of bleaching techniques on blood-stained teeth. MATERIAL AND METHODS: The teeth were stained by blood and allocated to groups: walking bleach, inside/outside, and in-office bleaching. L*, a*, b*, C*, h° color coordinates were measured using a clinical spectrophotometer at baseline, weekly (T1-T2-T3), and at 1-week (T4), 6-months (T5), and 1-year (T6) follow-up evaluations. ΔEab* , ΔE00 , and ΔWID were calculated between sequential evaluation timepoints and between baseline and each evaluation timepoint. Color coordinates and WID differences in each timepoint and technique were analyzed by Wilcoxon Signed Rank, Kruskal-Wallis and Mann-Whitney U test, respectively. ΔEab* , ΔE00 , and ΔWID were interpreted by color visual thresholds. RESULTS: The techniques presented a significant increase in L* and WID and, a significant decrease in a* and b* until the completion of treatments. Statistical differences between the techniques for a*, b* and WID were observed from T1 until T3. All techniques demonstrated excellent effectiveness for ΔEab* , ΔE00 , and ΔWID between baseline and each evaluation and follow-up timepoints. However, at T6, it was possible to identify a rebound effect for all techniques. CONCLUSIONS: All bleaching techniques presented excellent effectiveness. The stability of the whitening produced was maintained for 6 months. CLINICAL SIGNIFICANCE: Effective whitening of blood-stained teeth was achieved using walking bleach (sodium perborate), inside/outside (hydrogen peroxide - 7.5%) and in-office techniques (hydrogen peroxide - 35%). The bleaching techniques were effective after the completion of the treatments. A slight rebound was observed at 1 year follow-up.

Masking ability of resin composites: Effect of the layering strategy and substrate color.

OBJECTIVE: To evaluate the effect of layering strategy and substrate color on the masking ability of resin composites. MATERIALS AND METHODS: A1-shaded specimens from Charisma Diamond and Filtek Z350XT were produced using different layering strategies. Color measurements were made by a reflectance spectrophotometer over A2, C2, A3.5, C3, C4 substrates. Color differences were calculated and interpreted by the 50%:50% perceptibility and acceptability visual thresholds. Data was analyzed by Kruskal-Wallis and Dunn post hoc test. Chi-square test was used to determine the association between masking ability, and independent variables. RESULTS: Color differences were significantly lower on A2 and C2 in comparison with C4 for the majority of the layering strategies. Acceptable matches were observed on most of the combinations over A2. Moderately unacceptable mismatches were observed in most of the combinations over C2 and A3.5. Clearly unacceptable mismatches were observed on the C3 and C4. The ΔE00 color shifts were predominantly influenced by ΔL00 for all layering strategies and substrate colors. CONCLUSION: Masking ability was affected by the layering strategy and substrate color. Acceptable masking was associated with A2 and C2, and with layering strategy composed of 0.5 mm enamel opacity and 1.0 mm dentin opacity thicknesses, using the Filtek Z350XT. CLINICAL SIGNIFICANCE: Resin composites-shade A1-applied by different layering strategies with a final thickness of 1.5 mm were able to mask mild and moderately discolored substrates. Severely discolored substrates were not masked effectively.

Contributions of Microelectrochemical Scanning Techniques for the Efficient Detection of Localized Corrosion Processes at the Cut Edges of Polymer-Coated Galvanized Steel.

Spatially resolved information on corrosion reactions operating at the cut edges of coated metals can be obtained using microelectrochemical scanning techniques using a suitable selection of operation modes and scanning probes. The scanning vibrating electrode technique (SVET) provides current density maps with a spatial resolution of the order of the dimensions of the sample, which allows the temporal evolution of the corrosion reactions to be followed over time. This leads to the identification and localization of cathodic and anodic sites, although the technique lacks chemical specificity for the unequivocal identification of the reactive species. The application of scanning electrochemical microscopy (SECM) was previously limited to image cathodic reaction sites, either due to oxygen consumption in the amperometric operation or by the alkalinisation of the electrolyte in potentiometric operation. However, it is shown that anodic sites can be effectively monitored using an ion-selective microelectrode (ISME) as a probe. The ISME probes detected differences in the local concentrations of Zn2+ and OH- ions from the cut edges of a complete coil coating system compared to the same system after the polymeric layers were removed. In this way, it has been shown that the inhibitor loading in the polymer layers effectively contributes to reducing the corrosion rates at the cut edge, thus helping to extend the useful life of the sacrificial galvanized layer bonded directly to the steel matrix. Additionally, these two probe configurations can be integrated into a multi-electrode tip for potentiometric operation to simultaneously monitor localized changes in pH values and metal ion dissolution in a single scan. Spatial and temporal distributions were further investigated using different rastering procedures, and the potential of constructing pseudomaps for 2D-imaging is described.

Masking ability of bleach-shade resin composites using the multilayering technique.

OBJECTIVE: Evaluate the masking ability of bleach-shade resin composites applied by multilayering techniques over colored substrates. MATERIALS AND METHODS: Disc-shaped specimens were fabricated from bleach-shade resin composites using different multilayering techniques. Substrates were produced in opaque ceramic discs simulating colored substrates (A2, A3, A3.5, C2, C3, C4) and a bleached tooth (0M1). Color coordinates were obtained using a reflectance spectrophotometer. Color difference was calculated by CIEDE2000 using coordinates of 0 M1 ceramic as standard reference. Data were analyzed by one-way ANOVA and Tukey's post-hoc test (p ≤ 0.05). Masking ability interpretation was based on perceptibility and acceptability thresholds. RESULTS: All combinations presented ΔE00 above the acceptable threshold (ΔE00 >1.8), ranging from 2.49 to 7.42, regardless of the restorative system, multilayering strategy or substrate color. Multilayering combinations placed over A2, A3 and A3.5 were moderately (1.8<ΔE00 ≤3.6) and clearly unacceptable (3.6<ΔE00 ≤5.4), combinations associated with C2, C3 and C4 were clearly unacceptable and, extremely unacceptable (ΔE00 >5.4). Lower ΔE00 was observed for combinations with 0.5 mm extra white enamel layer (2.49), or 1.0 mm white dentin layer (2.69), over A2 and A3.5 substrates. Lightness difference showed the greatest contribution to ΔE00 . CONCLUSIONS: Bleach-shade resin composite systems applied by the multilayering technique were not able to ensure effective masking ability. CLINICAL SIGNIFICANCE: Bleach-shade resin composites applied with different combinations of the multilayering technique were not effective in masking colored substrates. Alternative strategies, techniques and dental materials should be explored to obtain acceptable masking.

Color, lightness, chroma, hue, and translucency adjustment potential of resin composites using CIEDE2000 color difference formula.

OBJECTIVE: To evaluate color, lightness, chroma, hue, and translucency adjustment potential of resin composites using CIEDE2000 color difference formula. METHODS: Three resin composites (Filtek Universal, Harmonize, and Omnichroma) were tested. Two types of specimens were prepared: an outer base shade with an inner hole filled with test shades and single-composite specimens of all shades. Spectrorradiometric reflectances measurements and subsequent CIELAB color coordinates and translucency parameter (TP) were performed. Color (CAP00 ), lightness, chroma, hue, and translucency (TAP00 ) adjustment potential using CIEDE2000 color difference were computed. Color and transparency differences among composite materials and shades were statistically tested (P < 0.05). RESULTS: Positive CAP00 and TAP00 values were found for majority of tested materials. CAP00 values ranged from -0.14 to 0.89, with the highest values found for Omnichroma (>0.75 in all cases). TAP00 values ranged from -0.06 to 0.86 with significant translucency differences among dual and single specimens. Omnichroma exhibited the highest adjustment potential for all color dimensions studied. CONCLUSIONS: Lightness, hue, chroma, and translucency adjustment potential have been introduced using CIEDE2000 color difference formula, and have shown their usefulness to evaluate blending effect in dentistry. Color coordinates and translucency adjustment potential were dependent on dental material. Omnichroma exhibited the most pronounced blending effect. CLINICAL SIGNIFICANCE: Resin composites with increased color and translucency adjustment may simplify shade selection, making this process easier and less time consuming. Furthermore, these materials might facilitate challenging and complex color matching situations.

Why ammonium detection is particularly challenging but insightful with ionophore-based potentiometric sensors - an overview of the progress in the last 20 years.

The monitoring of ammonium ion concentration has gained the attention of researchers from multiple fields since it is a crucial parameter with respect to environmental and biomedical applications. For example, ammonium is considered to be a quality indicator of natural waters as well as a potential biomarker of an enzymatic byproduct in key physiological reactions. Among the classical analytical methods used for the detection of ammonium ions, potentiometric ion-selective electrodes (ISEs) have attracted special attention in the scientific community because of their advantages such as cost-effectiveness, user-friendly features, and miniaturization ability, which facilitate easy portable measurements. Regarding the analytical performance, the key component of ISEs is the selective receptor, labelled as an ionophore in ISE jargon. Indeed, the preference of an ionophore for ammonium amongst other ions (i.e., selectivity) is a factor that primarily dictates the limit of detection of the electrode when performing measurements in real samples. A careful assessment of the literature for the last 20 years reveals that nonactin is by far the most employed ammonium ionophore to date. Despite the remarkable cross-interference of potassium over the ammonium response of nonactin-based ISEs, analytical applications comprising water quality assessment, clinical tests in biological fluids, and sweat monitoring during sports practice have been successfully researched. Nevertheless, there is evident difficulty in the determination of close-to-micromolar levels of ammonium in real samples with a significant potassium background level (i.e., millimolar concentration). This fact has fostered the search for a large variety of ammonium ionophores over the years, which are critically inspected herein. Overall, we provide an easily readable state of the art accompanied by a comprehensive description of other types of ammonium electrodes, including commercially available units. We conclude that newer breakthroughs are still required in the field to reach the desired analytical applications.

Characterization of the chloroquine-induced mouse model of pruritus using an automated behavioural system.

Pruritus is a major symptom of several dermatological diseases but has limited therapeutic options available. Animal models replicating the pathophysiology of pruritus are needed to support the development of new drugs. Induction of pruritus by chloroquine (CQ) in mice is widely used, although, as with similar models, it has low throughput and does not distinguish between antipruritic effects and confounding factors such as sedation. To overcome these issues, we incorporated into the model an automated system that measures both scratching and locomotor behaviour simultaneously. We combined this system with the determination of CQ levels in different tissues to understand the impact of the route of CQ administration on the pruritogenic response. We concluded that whereas oral CQ does not induce pruritus due to insufficient skin levels, the bell-shaped curve of pruritus observed following subcutaneous administration is due to toxicity at high doses. We validated the model with several drugs currently used in humans: nalfurafine, aprepitant, cyproheptadine and amitriptyline. By comparing the effects of the drugs on both scratching and locomotor activity, we concluded that nalfurafine and aprepitant can exhibit efficacy at doses devoid of central effects, whereas central effects drove the efficacy of the other two drugs. This was further confirmed using non-brain-penetrant drugs. Moreover, as anticipated, anti-inflammatory drugs showed no efficacy. In conclusion, the use of an automated integrated behavioural assessment in CQ-induced pruritus makes the assay suitable for screening purposes and allows for a correct interpretation of the antipruritic effect of the compounds evaluated.

Lipschütz ulcers in twin sisters.

Lipschütz ulcer (LU) is an uncommon condition that usually affects prepubertal and pubertal girls. It can be misdiagnosed as a sexually transmitted disease or even as a sign of child abuse, causing great anxiety to patients and their families. We present two cases of LU consecutively affecting twin sisters. To our knowledge, this is the first case in two family members, supporting infectious transmission. We propose airborne transmission as the most probable cause in our cases.

Masking Ability of the Combined Application of Opaquers and Resin Composite on Discolored Backgrounds.

The aim of this study was to evaluate the masking ability of a combined application of opaquers and resin composite over discolored backgrounds: A3, A3.5, C2, C3, and C4. The groups were divided according to the opaquer brand, the number of opaquer coats (one or two), and the thickness of the resin composite layer (0.5 or 1.0 mm). The color measurements were made by a reflectance spectrophotometer (SP60, EX-Rite). The color difference between the opaquer + resin composite + background and a reference background was calculated using the CIEDE2000 formula. ANOVA and Tukey's post hoc test (α=0.05) were used to analyze the ΔE00 mean values. A bivariate analysis was used to determine the association between dependent and independent variables. The masking ability was rated by the ΔE00 visual thresholds of acceptability and perceptibility (Excellent Match: ΔE00 ≤ 0.8; Acceptable Match: 0.8 < ΔE00 ≤1.8; Moderately Unacceptable Mismatch: 1.8 < ΔE00 ≤ 3.6; Clearly Unacceptable Mismatch: 3.6 < ΔE00 ≤ 5.4; Extremely Unacceptable Mismatch: ΔE00 > 5.4). The mean ΔE00 values ranged from 0.5 to 5.52. Masking ability was affected by the opaquer brand, thickness of the resin composite layer, and background shades. Most of the combinations that achieved either excellent or acceptable masking ability were obtained with combinations composed of one or two coats of opaquer and a 1.0-mm-thick resin composite layer for all backgrounds except C4. Acceptable results were also obtained for combinations with 0.5-mm-thick resin composite over C2, A3, and A3.5 backgrounds.

Evaluation of in vitro corrosion resistance and in vivo osseointegration properties of a FeMnSiCa alloy as potential degradable implant biomaterial.

In vitro electrochemical characterization and in vivo implantation in an animal model were employed to evaluate the degradation behaviour and the biological activity of FeMnSi and FeMnSiCa alloys obtained using UltraCast (Ar atmosphere) melting. Electrochemical characterization was based on open circuit potential measurement, electrochemical impedance spectroscopy and potentiodynamic polarization techniques while the alloys were immersed in Ringer's solution at 37 °C for 7 days. Higher corrosion rates were measured for the Ca-containing material, resulting from inefficient passivation of the metal surface by oxy-hydroxide products. In vivo osseointegration was investigated on a tibia implant model in rabbits by referring to a standard control (AISI 316 L) stainless steel using standard biochemical, histological and radiological methods of investigation. Changes in the biochemical parameters were related to the main stages of the bone defect repair, whereas implantation of the alloys in rabbit's tibia provided the necessary mechanical support to the injured bone area and facilitated the growth of the newly connective tissue, as well as osteoid formation and mineralization, as revealed by either histological sections or computed tomography reconstructed images and validated by the bone morphometric indices. The present study highlighted that the FeMnSiCa alloy promotes better osteoinduction and osseconduction processes when compared to the base FeMnSi alloy or with AISI 316 L, and in vivo degradation rates correlate well with corrosion resistance measurements in Ringer's solution.

Major depression in hospitalized Argentine general medical patients: Prevalence and risk factors.

BACKGROUND: Depression is not uncommon among medically hospitalized patients, though reported prevalence has varied widely, often in samples involving elderly patients with particular illnesses. Accordingly, we evaluated risk of major depression in three metropolitan general hospitals in Buenos Aires, in subjects with a range of medical disorders and ages, comparing several standard screening methods to expert clinical examinations. METHODS: Consecutively hospitalized general medical patients were evaluated over a six-months. Excluded were subjects under age 18 and those unable to participate in assessments because of illness, medication, sensory or speech impairment, or lack of language fluency, or scored <25 on the Mini Mental State Examination (MMSE). Consenting participants were examined for DSM-IV-TR major depression by psychiatrists guided by MINI examinations, compared with other standard screening methods. Risk factors were assessed by preliminary bivariate analyses followed by multivariate logistic regression modeling. RESULTS: Overall prevalence of major depression in 257 subjects was 27% by psychiatric examination. The rate was most similar (25%) with the Hospital Anxiety & Depression Scale (HADS), and much higher with the Beck Depression Inventory-II (BDI, 44%) and Patient Health Questionnaire (PHQ, 56%). Factors associated independently with depression by multivariate modeling included: prior psychotropic-drug treatment, female sex, more children, and heavy smoking. Depression was associated most with neoplastic, urological, and infectious disorders, least with pulmonary, neurological, and hematologic conditions. LIMITATIONS: Modest numbers limited power to test for associations of depression with specific medical conditions. CONCLUSIONS: Major depression was identified in over one-quarter of Argentine, general medical inpatients, with marked differences among screening methods. Several risk factors were identified. The findings encourage assertive identification of depression in hospitalized medical patients using valid, reliable, and cost-effective means of improving their care.

[Theoretical estimation of the epidemiological impact of hepatitis A infection in Colombia]. / Estimación del impacto de la infección por Hepatitis A en zonas urbanas de Colombia 2008: Un análisis a partir de datos secundarios.

BACKGROUND: Hepatitis A vaccination is justified in areas with an intermediate endemicity of the infection. AIM: To estimate the epidemiological impact of hepatitis A infection in Colombia. MATERIAL AND METHODS: Epidemiological indicators of hepatitis A infection prevalence by age, morbidity by age, and lethality by age were estimated from a literature search. These measures were projected on a hypothetical cohort of children followed from birth until 15 years of age. The number of cases of infection, jaundice, hepatic failure, hospitalizations and deaths were estimated. RESULTS: From birth to adolescence, a cohort of 872 923 urban children in Colombia would generate between 312,331 and 598,591 infections, between 13,586 and 25,960 hospitalizations, between 213 and 407 hepatic failures and between 107 and 204 deaths. CONCLUSIONS: The impact of hepatitis A infection in Colombia, is important. Introducing hepatitis A vaccination would reduce a substantial number of severe hepatitis A cases.

Atypical Pityriasis rosea in a black child: a case report.

INTRODUCTION: Pityriasis rosea is a self-limited inflammatory condition of the skin that mostly affects healthy children and adolescents. Atypical cases of Pityriasis rosea are fairly common and less readily recognized than typical eruptions, and may pose a diagnostic challenge. CASE PRESENTATION: We report the case of a 12-year-old black child that developed an intense pruritic papular eruption with intense facial involvement that was diagnosed of Pityriasis rosea and resolved after five weeks leaving a slight hyperpigmentation. CONCLUSION: Facial and scalp involvement, post-inflammatory disorders of pigmentation and papular lesions are characteristics typically associated to black patients with Pityriasis rosea. The knowledge of features found more frequently in dark-skinned population may be helpful to physicians for diagnosing an atypical Pityriasis rosea in these patients.