Intralesional Triamcinolone for Fistulous Tracts in Hidradenitis Suppurativa: An Uncontrolled Prospective Trial with Clinical and Ultrasonographic Follow-Up.

BACKGROUND: There is little evidence on the use of intralesional triamcinolone (ILT) for managing fistulous tracts in hidradenitis suppurativa (HS). OBJECTIVE: To assess the clinical and ultrasound response to ILT for single fistulous lesions in HS patients. METHODS: A prospective open-label study was conducted to assess response to ILT (40 mg/mL) for fistulous tracts in HS. Consecutive patients (Hurley II stage exclusively) presenting to our department were recruited from August 2016 to August 2018. They received a single injection of ILT as the sole treatment. Lesions were assessed clinically and by ultrasound at baseline and 90 days. RESULTS: Of the 53 included HS patients with fistulous tracts, 36 (67.9%) were women, 30 (56.6%) were smokers, and 36 (67.9%) were obese or overweight (body mass index ≥25). Median Sartorius score was 9.0 (IQR 9.0-36.0), and median duration of the lesion treated was 6 months (IQR 3.0-12.0). Fistulous tracts were injected with 0.5 mL triamcinolone 40 mg/mL. Seven patients were lost to follow-up. At 90 days, 20 (43.5%) lesions showed clinical and ultrasound resolution, 13 (28.3%) showed only clinical resolution while persisting on ultrasound, and 13 (28.3%) persisted both clinically and on ultrasound. Mean clinical size decreased from 17.0 to 5.1 mm (p < 0.0001), while mean length on ultrasound decreased from 16.0 to 8.6 mm (p < 0.0001). LIMITATIONS: Small sample size and no control group. CONCLUSIONS: Our study suggests that ILT is beneficial for small fistulous tracts in HS.

What a pooled data study tells us about the relationships between gender and knowledge of semantic categories.

Introduction: Both the neuropsychological study of patients with category-specific semantic disorders (CSSD) and the experimental research on categorical processing in healthy subjects (HSs) have shown that men are mainly impaired with fruits and vegetables and women with animals and artifacts. Since this difference is more striking in patients with CSSD than in HSs, we hypothesized that the lack of power of some investigations conducted with HSs and the different methods used in studies conducted with HSs and patients with CSSD could explain some of these inconsistencies and that a study conducted with a very large number of HSs using visual naming tasks should strongly confirm the role of gender in categorical tasks. Methods: Picture naming data gathered during the last ten years with our category-specificity paradigm from a large number (702) of HSs were reanalyzed. Results: As predicted, men named significantly more animals and artifacts, while women named more plant life items. Discussion: These data confirm that, if different domains of knowledge are studied in a very large sample of HSs using a picture naming task equivalent to the naming tasks used in most anatomo-clinical studies on CSSD, then the gender effects are highly significant.

Noninvasive Prenatal Testing: Comparison of Two Mappers and Influence in the Diagnostic Yield.

OBJECTIVE: The aim of this study was to determine if the use of different mappers for NIPT may vary the results considerably. METHODS: Peripheral blood was collected from 217 pregnant women, 58 pathological (34 pregnancies with trisomy 21, 18 with trisomy 18, and 6 with trisomy 13) and 159 euploid. MPS was performed following a manufacturer's modified protocol of semiconductor sequencing. Obtained reads were mapped with two different software programs: TMAP and HPG-Aligner, comparing the results. RESULTS: Using TMAP, 57 pathological samples were correctly detected (sensitivity 98.28%, specificity 93.08%): 33 samples as trisomy 21 (sensitivity 97.06%, specificity 99.45%), 16 as trisomy 18 (sensibility 88.89%, specificity 93.97%), and 6 as trisomy 13 (sensibility 100%, specificity 100%). 11 false positives, 1 false negative, and 2 samples incorrectly identified were obtained. Using HPG-Aligner, all the 58 pathological samples were correctly identified (sensibility 100%, specificity 96.86%): 34 as trisomy 21 (sensibility 100%, specificity 98.91%), 18 as trisomy 18 (sensibility 100%, specificity 98.99%), and 6 as trisomy 13 (sensibility 100%, specificity 99.53%). 5 false positives were obtained. CONCLUSION: Different mappers use slightly different algorithms, so the use of one mapper or another with the same batch file can provide different results.

Association of General and Abdominal Obesity With Hypertension, Dyslipidemia and Prediabetes in the PREDAPS Study.

INTRODUCTION AND OBJECTIVES: Some anthropometric measurements show a greater capacity than others to identify the presence of cardiovascular risk factors. This study estimated the magnitude of the association of different anthropometric indicators of obesity with hypertension, dyslipidemia, and prediabetes (altered fasting plasma glucose and/or glycosylated hemoglobin). METHODS: Cross-sectional analysis of information collected from 2022 participants in the PREDAPS study (baseline phase). General obesity was defined as body mass index ≥ 30kg/m2 and abdominal obesity was defined with 2 criteria: a) waist circumference (WC) ≥ 102cm in men/WC ≥ 88cm in women, and b) waist-height ratio (WHtR) ≥ 0.55. The magnitude of the association was estimated by logistic regression. RESULTS: Hypertension showed the strongest association with general obesity in women (OR, 3.01; 95%CI, 2.24-4.04) and with abdominal obesity based on the WHtR criterion in men (OR, 3.65; 95%CI, 2.66-5.01). Hypertriglyceridemia and low levels of high-density lipoprotein cholesterol showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.49; 95%CI, 1.68-3.67 and OR, 2.70; 95%CI, 1.89-3.86) and with general obesity in men (OR, 2.06; 95%CI, 1.56-2.73 and OR, 1.68; 95%CI, 1.21-2.33). Prediabetes showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.48; 95%CI, 1.85-3.33) and with abdominal obesity based on the WC criterion in men (OR, 2.33; 95%CI, 1.75-3.08). CONCLUSIONS: Abdominal obesity indicators showed the strongest association with the presence of prediabetes. The association of anthropometric indicators with hypertension and dyslipidemia showed heterogeneous results.

Ultrasound Evaluation as a Complementary Test in Hidradenitis Suppurativa: Proposal of a Standarized Report.

BACKGROUND: Staging and monitoring of patients with hidradenitis suppurativa (HS) have been traditionally based on clinical findings. However, the physical examination may show important limitations because of its poor sensitivity for differentiating between different lesion subtypes, and its low sensitivity to define the disease's activity. OBJECTIVE: To develop a consensus ultrasound (US) report that could summarize the relevant anatomical characteristics and staging of patients considering the experience of radiologists and dermatologists working on imaging of HS. METHODS: A questionnaire on different aspects related to US examination in HS was performed. A working group, called DERMUS, composed of doctors from 9 countries who have been working in dermatologic US applied in patients with HS on a regular basis were included to evaluate the different items provided. RESULTS: A consensus US report to evaluate HS patients was established. CONCLUSION: The authors present the first attempt to define a HS standardized sonographic report. This model would be the first effort to include this imaging technique as the first elective medical test for staging and monitoring patients, which can support therapeutic decisions by providing earlier, objective, deeper, anatomical, and comparative evaluations in this difficult to treat disease.

Why Almost Always Animals? Ranking Fluency Tasks for the Detection of Dementia Based on Receiver Operating Characteristic (ROC) and Quality ROC Analyses.

BACKGROUND/AIMS: Category fluency tasks have been widely used to assess cognitive functioning in both clinical and experimental environments as an index of cognitive and psycholinguistic dysfunctions in dementia. Typically, a reduced group of semantic categories has been selected for neuropsychological assessment (e.g., animals, fruits or vegetables), although empirical support for the prevalence of one category among others is absent in the literature. METHODS: We provide an empirical evaluation of the ability of 14 category fluency tasks to discriminate between subjects with dementia of the Alzheimer type and healthy elderly participants. As a novelty, we used both receiver operating characteristic (ROC) curves and quality ROC calibrated analyses to characterize the interplay of sensitivity and specificity of every category fluency task performance as a screening tool. The use of calibrated measures provided us with a useful tool for comparing the diagnostic ability of the different categories, as well as making rankings of categories based on the quality indices of efficiency, sensitivity, and specificity. RESULTS: The habitually used category of animals is far from being the most efficient one in terms of its diagnostic power to evaluate dementia. CONCLUSION: Our study might guide the selection of suitable category fluency tasks according to the diagnostic purposes in dementia.

On Colour, Category Effects, and Alzheimer's Disease: A Critical Review of Studies and Further Longitudinal Evidence.

The role of colour in object recognition is controversial; in this study, a critical review of previous studies, as well as a longitudinal study, was conducted. We examined whether colour benefits the ability of Alzheimer's disease (AD) patients and normal controls (NC) when naming items differing in colour diagnosticity: living things (LT) versus nonliving things (NLT). Eleven AD patients were evaluated twice with a temporal interval of 3 years; 26 NC were tested once. The participants performed a naming task (colour and greyscale photographs); the impact of nuisance variables (NVs) and potential ceiling effects were also controlled. Our results showed that (i) colour slightly favoured processing of items with higher colour diagnosticity (i.e., LT) in both groups; (ii) AD patients used colour information similarly to NC, retaining this ability over time; (iii) NVs played a significant role as naming predictors in all the participants, relegating domain to a minor plane; and (iv) category effects (better processing of NLT) were present in both groups. Finally, although patients underwent semantic longitudinal impairment, this was independent of colour deterioration. This finding provides better support to the view that colour is effective at the visual rather than at the semantic level of object processing.

The Nombela 2.0 semantic battery: an updated Spanish instrument for the study of semantic processing.

In this study, the Nombela 2.0 semantic battery is presented. This is a new version of its earlier precedent: the battery Nombela (I), in an attempt to improve it (dealing with ceiling effects) and reducing the application time by decreasing the number of tasks. The battery is constructed on a common set of 98 stimuli, including both living and nonliving semantic domains. It consists of five tasks designed to explore category specificity by tapping semantic production and comprehension, using both visual and verbal input. All of the items were rated according to Spanish norms, as stated in a previous study of our group, and all of the tasks were matched across domain on six nuisance variables. The present study has two goals: (i) to make available the updated version (2.0) of the Nombela semantic memory battery and (ii) to characterize and compare the neuropsychological profiles of two different patient groups: mild cognitive impairment and Alzheimer disease, with regard to normal controls.

Spanish norms for age of acquisition, concept familiarity, lexical frequency, manipulability, typicality, and other variables for 820 words from 14 living/nonliving concepts.

This article presents a new corpus of 820 words pertaining to 14 semantic categories, 7 natural (animals, body parts, insects, flowers, fruits, trees, and vegetables) and 7 man-made (buildings, clothing, furniture, kitchen utensils, musical instruments, tools, and vehicles); each word in the database was collected empirically in a previous exemplar generation study. In the present study, 152 Spanish speakers provided data for four psycholinguistic variables known to affect lexical-semantic processing in both neurologically intact and brain-damaged participants: age of acquisition, familiarity, manipulability, and typicality. Furthermore, we collected lexical frequency data derived from Internet search hits, plus three additional Spanish lexical frequency indexes. Word length, number of syllables, and the proportion of respondents citing the exemplar as a category member-which can be useful as an additional measure of typicality-are also provided. Reliability and validity indexes showed that our items display characteristics similar to those of other corpora. Overall, this new corpus of words provides a useful tool for scientists engaged in cognitive- and neuroscience-based research focused on examining language, memory, and object processing. The full set of norms can be downloaded from www.psychonomic.org/archive.

Reelin-dependent ApoER2 downregulation uncouples newborn neurons from progenitor cells.

Reelin and its receptor machinery are well known to be required for the migration and positioning of neocortical projection neurons. More recently, reelin has been shown both necessary and sufficient to determine the rate of neocortical neurogenesis. The molecular links underlying its seemingly distinct proliferative and post-proliferative functions remain unknown. Here we reveal an enriched expression of functional reelin receptors, largely of Apolipoprotein E Receptor 2 (ApoER2), in radial glia basal processes and intermediate progenitor cells during mid/late cortical development. In vivo, ApoER2 overexpression inhibits neuronal migration. In contrast, precluding excessive levels of ApoER2 in reelin-deficient cortices, by either ApoER2 knock-down or the transgenic expression of reelin in neural progenitor cells, improves neuronal migration and positioning. Our study provides groundwork for the highly orchestrated clearance of neocortical neurons from their birth site, suggesting that a reelin-dependent ApoER2 downregulation mechanism uncouples newborn neurons from progenitor cells, thereby enabling neurons to migrate.

Noninvasive fetal sex determination in maternal plasma: a prospective feasibility study.

PURPOSE: To prospectively validate a protocol for noninvasive fetal sex determination in maternal plasma and demonstrate its applicability to clinical practice. METHODS: Peripheral blood from 404 pregnant women undergoing prenatal invasive testing was collected from 6 to 23 weeks of gestation. Real-time PCR was performed for the SRY gene and multicopy DYS14 marker sequence located within the TSPY gene by the TaqMan minor groove binder probe assay as a first-line test. Owing to a false-positive result, amplification of repetitive motifs of the DAZ gene region was also tested as a second-line test performed in the last 232 patients enrolled in our series. A diagnostic algorithm was designed using a combination of these three markers. Fetal gender determined by noninvasive prenatal diagnosis (NIPD) was compared with that diagnosed by quantitative fluorescent PCR after invasive testing or ultrasound. RESULTS: A single false-positive result was obtained in the first 172 pregnancies. Reporting criteria were modified in the subsequent 232 pregnancies, giving an overall sensitivity and specificity of 100% (95% CI 99.8-100%) and 99.5% (95% CI 98.1-100%), respectively. Pregnancy outcome was obtained in all cases, including 221 male-bearing and 183 female-bearing pregnancies. CONCLUSION: NIPD for fetal sex determination in maternal plasma is highly accurate and clinically applicable if robust reporting criteria are applied.

Domain or not domain? That is the question: longitudinal semantic deterioration in Alzheimer's disease.

Category specific semantic impairment (e.g. living versus nonliving things) has been reported in association with various pathologies, including herpes simplex encephalitis and semantic dementia. However, evidence is inconsistent regarding whether this effect exists in diseases progressively impacting diverse cortical regions, such as Alzheimer's disease (AD). Ceiling effects producing non-Gaussian distributions and poor control for confounds such as nuisance variables (e.g. familiarity) may contribute to this discrepancy. Fourteen AD patients were longitudinally studied examining category effects on three semantic tasks (picture naming, naming to description and word to picture matching) matched across domain on all known nuisance variables (NV). To address non-Gaussian distributions, we run bootstrap analyses to determine whether NV, semantic domain or control performance best predicted AD patient performance. Multiple hierarchical regression analyses revealed that, whilst NV accounted for most of the explained variance in patients in the three tasks, the influence of semantic domain was substantially lower. Individual logistic regression demonstrated a significant category effect in only a few patients and healthy controls. No significant qualitative changes were observed in patients over time. Our results confirm the importance of NVs as predictors of AD patient performance, suggesting that the role of semantic domain is not a useful predictor of the progressive deterioration in AD.

Size matters: a study on naming and size knowledge in dementia of the Alzheimer type.

Category-specificity was longitudinally studied over a period of 12 months in seven Alzheimer disease patients, with two semantic tasks differing with respect to verbal processing demands: picture naming and a size ordering task. Items from each task were matched on all cognitive and psycholinguistic variables known to differ across domains (living-nonliving). Naming performance of patients was poorer than that of normal controls. Regarding category-specific effects, while naming performance of patients was parallel to that of normal controls, patients' performance with the size ordering task revealed a different scaling of living things while that of nonliving things mirrored performance of normal controls. This suggests that caution is needed when the picture naming task is exclusively used to document category-specific effects.

Downregulation of functional Reelin receptors in projection neurons implies that primary Reelin action occurs at early/premigratory stages.

Reelin signaling is essential for correct development of the mammalian brain. Reelin binds to apolipoprotein E receptor 2 and very low-density lipoprotein receptor and induces phosphorylation of Dab1. However, when and where these reactions occur is essentially unknown, and the primary function(s) of Reelin remain unclear. Here, we used alkaline phosphatase fusion of the receptor-binding region of Reelin to quantitatively investigate the localization of functional Reelin receptors (i.e., those on the plasma membrane as mature forms) in the developing brain. In the wild-type cerebral cortex, they are mainly present in the intermediate and subventricular zones, as well as in radial fibers, but much less in the cell bodies of the cortical plate. Functional Reelin receptors are much more abundant in the Reelin-deficient cortical plate, indicating that Reelin induces their downregulation and that it begins before the neurons migrate out of the intermediate zone. In the wild-type cerebellum, functional Reelin receptors are mainly present in the cerebellar ventricular zone but scarcely expressed by Purkinje cells that have migrated out of it. It is thus strongly suggested that Reelin exerts critical actions on migrating projection neurons at their early/premigratory stages en route to their final destinations, in the developing cerebral cortex and cerebellum.

The impact of dementia, age and sex on category fluency: greater deficits in women with Alzheimer's disease.

A category specific effect in naming tasks has been reported in patients with Alzheimer's dementia. Nonetheless, naming tasks are frequently affected by methodological problems, e.g., ceiling effects for controls and "nuisance variables" that may confound results. Semantic fluency tasks could help to address some of these methodological difficulties, because they are not prone to producing ceiling effects and are less influenced by nuisance variables. One hundred and thirty-three participants (61 patients with probable AD; and 72 controls: 36 young and 36 elderly) were evaluated with semantic fluency tasks in 14 semantic categories. Category fluency was affected both by dementia and by age: while in nonliving-thing categories there were differences among the three groups, in living thing categories larger lexical categories produced bigger differences among groups. Sex differences in fluency emerged, but these were moderated both by age and by pathology. In particular, fluency was smaller in female than male Alzheimer patients for almost every subcategory.

No category specificity in Alzheimer's disease: a normal aging effect.

The authors examined category effects on tasks of picture naming, naming to definition, and word-picture matching in 38 patients with Alzheimer's disease (AD) and 30 elderly controls. Each task was matched across category on all "nuisance" variables known to differ across domains. Standard analyses revealed significant category disadvantages for classifying living things in AD patients but also for elderly controls on each task. To overcome the ceiling effect in controls, the authors conducted 1,000 bootstrap analyses of covariance, with control performance as a difficulty index covariate. These covariate analyses eliminated the category effect in AD patients on all 3 tasks. Indeed, the authors report that control performance accounted for 64% (picture naming), 49% (naming to description), and 42% (word-picture matching) of variance in AD performance. This suggests that, although category effects in AD patients do not reflect intrinsic variables, the size and direction of the category effect are not different from those in elderly controls.

A meta-analytic review of category naming in Alzheimer's disease.

Patients with Alzheimer's disease (AD) experience word-finding difficulties that become increasingly pronounced as pathological changes accrue in the brain. One question that has received increasing attention over the last two decades concerns whether the anomia in AD is category-specific, i.e. differentially affects the ability to name living things (LT) and non-living things (NLT). The current meta-analysis systematically reviewed the effect sizes for naming pictures of LT and NLT in comparisons of AD patients and healthy controls in 21 studies with over 1000 participants (557 patients and 509 healthy controls). A random effects model analysis revealed no significant difference in the large weighted effect sizes for naming pictures of LT and NLT (d=1.76 and 1.49, respectively). Moderator variable analyses revealed a significant impact of stimulus colour on the effect size for LT, indicating that using colour stimuli significantly increases the impairment of naming LT in AD patients. Additionally, we found that LT and the NLT effect sizes were larger for samples with proportionally more female patients; smaller samples produced larger LT effect sizes. In contrast, effect sizes were not significantly related to dementia severity, patient age, the number of stimuli, years of education, or the number of matching variables controlled.

An attenuation of the 'normal' category effect in patients with Alzheimer's disease: a review and bootstrap analysis.

There is a consensus that Alzheimer's disease (AD) impairs semantic information, with one of the first markers being anomia i.e. an impaired ability to name items. Doubts remain, however, about whether this naming impairment differentially affects items from the living and nonliving knowledge domains. Most studies have reported an impairment for naming living things (e.g. animals or plants), a minority have found an impairment for nonliving things (e.g. tools or vehicles), and some have found no category-specific effect. A survey of the literature reveals that this lack of agreement may reflect a failure to control for intrinsic variables (such as familiarity) and the problems associated with ceiling effects in the control data. Investigating picture naming in 32 AD patients and 34 elderly controls, we used bootstrap techniques to deal with the abnormal distributions in both groups. Our analyses revealed the previously reported impairment for naming living things in AD patients and that this persisted even when intrinsic variables were covaried; however, covarying control performance eliminated the significant category effect. Indeed, the within-group comparison of living and nonliving naming revealed a larger effect size for controls than patients. We conclude that the category effect in Alzheimer's disease is no larger than is expected in the healthy brain and may even represent a small diminution of the normal profile.