Interventions for chronic palmoplantar pustulosis: abridged Cochrane systematic review and GRADE assessments.

BACKGROUND: Palmoplantar pustulosis (PPP) is a chronic inflammatory disease in which sterile and relapsing pustules appear on the palms and soles. OBJECTIVES: To assess the effects of interventions for chronic PPP to induce and maintain complete remission. METHODS: We searched for randomized controlled trials (RCTs), including people with PPP or chronic palmoplantar pustular psoriasis, in the Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, LILACS and eight trials registers up to July 2020. Study selection, data extraction and risk-of-bias assessment were carried out independently by two review authors. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method. RESULTS: We included 37 RCTs (1663 participants, 76% women, mean age 50 years). Mean treatment duration was 11 weeks. Topical vitamin D derivative may be more effective than placebo in achieving clearance [risk ratio (RR) 7·83, 95% confidence interval (CI) 1·85-33·12; low-certainty evidence from two trials]. Concerning biological therapies, there was little or no difference between etanercept and placebo in achieving clearance (low-certainty evidence from one trial), ustekinumab is less effective than placebo in reducing severity (low-certainty evidence from one trial), and guselkumab (RR 2·88, 95% CI 1·24-6·69) and secukinumab (RR 1·55, 95% CI 1·02-2·35) are probably better in reducing disease severity (moderate-certainty evidence from two and one trial(s), respectively) but may cause more serious adverse events than placebo. CONCLUSIONS: Evidence is lacking for or against major chronic PPP treatments. Risk of bias and imprecision limit our confidence in the results.

Minimally invasive colorectal surgery.

Adoption of laparoscopic colorectal surgery has been slow. In the United States, of approximately 250,000 colectomies each year, only 5% to 15% of these cases are being done laparoscopically. Laparoscopic colorectal surgery can be performed successfully on patients for both benign and malignant conditions in any anatomic location of the colon and rectum. The COST trial definitively established that laparoscopic colon surgery for cancer had similar rates of local recurrence and survival compared to open surgery, with better short-term outcomes. It demonstrated that laparoscopic resections resulted in shorter hospital stays, decreased IV narcotics and oral analgesics, and improved quality of life within two weeks of surgery. In the authors' clinical experience of more than 1500 laparoscopic surgeries, patients who undergo laparoscopic colorectal surgery experience decreased rates of wound infection, hernia, and bowel obstruction. One of the challenges of laparoscopic colorectal surgery is standardizing these complex, minimally invasive procedures in the operating room. With standard techniques, one can create optimal outcomes for patients, minimizing perioperative complications and maximizing oncologic results. This paper describes a sequenced step approach for each procedure to facilitate this. Left colectomy follows a nine-step process, and right colectomy follows a four-step process. Both of these procedures are described in detail. The newest horizon in minimally invasive surgery is single incision surgery, which allows for colorectal resections through a single 2.5 cm incision, producing an excellent cosmetic result. Based on this chapter, we advocate the laparoscopic approach be used as the primary method for colorectal surgery.

Non-typhoidal Salmonella rates in febrile children at sites in five Asian countries.

There is increased recognition of non-typhoidal Salmonella (NTS) as a major cause of severe febrile illness in sub-Saharan Africa. However, little is known about community-based incidence of NTS in Asia. In a multicentre, community-based prospective Salmonella surveillance study, we identified a total of six NTS cases: three in Karachi, Pakistan, one in Kolkata, India, and two in North Jakarta, Indonesia. No NTS cases were identified in Hechi, People's Republic of China, and Hue, Viet Nam. Three cases were in children under 3 years, and one case was in a child aged 10 years and one in a child aged 15 years. Only one case was an adult (29 years). The highest incidence of NTS infection was in Karachi (7.2 culture-proven NTS cases per 100,000 person years in age group of 2-15 years). However, in comparison with sub-Saharan Africa, the NTS burden in Asia appears rather limited.

Private demand for cholera vaccines in Hue, Vietnam.

OBJECTIVES: This study aims to measure the private demand for oral cholera vaccines in Hue, Vietnam, an area of relatively low endemicity of cholera, using the contingent valuation method. METHODS: Interviews were conducted with either the head of household or spouse in 800 randomly selected households with children less than 18 years old. Respondents were asked whether they would purchase an oral cholera vaccine with different levels of effectiveness and durations of effectiveness (both for themselves and for other household members) at a specified price. RESULTS: The median respondent willingness to pay for 50% effective/3-year vaccine was estimated to be approximately $5, although 17% of the study sample would not pay for a cholera vaccine. The median economic benefit to a household of vaccinating all household members against cholera, as measured by its stated willingness to pay, was estimated to be $40 for a vaccine with these attributes. CONCLUSIONS: The perceived private economic benefits of a cholera vaccine were high, but not evenly distributed across the population. A minority of the people in Hue place no value on receiving a cholera vaccine.

Supplementation of whole persimmon leaf improves lipid profiles and suppresses body weight gain in rats fed high-fat diet.

The objective of this study was to investigate the hypolipidemic effects of powdered whole persimmon leaf supplement in rats fed high-fat diet. Three groups of male Sprague-Dawley rats during 6 weeks were fed different diet: normal control (NC), high-fat (HF), and high-fat supplemented with powdered whole persimmon leaf (PL; 5%, wt/wt) groups. Body weight and relative weight of interscapular brown adipose tissue were significantly lower in the PL group than in the HF group, while plasma leptin concentration was higher. The supplementation of persimmon leaf significantly lowered the plasma total cholesterol and triglyceride concentrations, whereas elevated the ratio of HDL-C/total-C and improved the atherogenic index. Persimmon leaf supplementation led the hepatic cholesterol and triglyceride values to similar levels to the NC group. Accumulation of hepatic lipid droplets and the epididymal white adipocyte size of PL group were diminished comparing to the HF group. Hepatic HMG-CoA and ACAT activities were significantly higher in the PL group than in other groups. Contents of fecal triglyceride, cholesterol and acidic sterol were significantly higher in the PL group than in the HF group. Accordingly, we suggest that supplementation of the powdered whole persimmon leaf improves plasma and hepatic lipid levels profile partly via the increased fecal lipids in high-fat fed rats. These beneficial effects may be due to the properties of its phenolic compounds (1.15 g/100g) and high fiber (63.48 g/100g) content in the powdered persimmon leaf.

Production of a new wheat line possessing the 1BL.1RS wheat-rye translocation derived from Korean rye cultivar Paldanghomil.

The 1BL.1RS translocations between wheat ( Triticum aestivum L.) and rye ( Secale cereale L.) are widely used in bread wheat breeding programs, but all modern wheat cultivars with the 1BL.1RS have shown genetic vulnerability due to one rye source - a German cultivar, Petkus. We have developed, a new 1BL.1RS wheat-rye translocation line from the backcross of the F(1) hybrid of wheat cv. Olmil and rye cv. Paldanghomil, both cultivars from Korea. The GISH technique was applied to identify the presence of rye chromatin in 467 BC(1)F(6) lines selected from 77 BC(1)F(5) lines. Only one line, Yw62-11, showed wheat-rye translocated chromosomes, with a somatic chromosome number of 2n=42. C-banding patterns revealed that the translocated chromosome was 1BL.1RS, showing prominent bands in the terminal and sub-terminal regions of the short arm as well as in the centromeric region and terminal region of the long arm. This new 1BL.1RS translocation line formed 21 bivalents like common wheat at meiotic metaphase I, thereby showing complete homology.

BAC FISH analysis in Allium cepa.

Onion (Allium cepa L.; 1C=15,000 Mb) is an agriculturally important plant. The genome of onion has been extensively studied at the conventional cytogenetic level, but molecular analyses have lagged behind due to its large genome size. To overcome this bottleneck, a partial bacterial artificial chromosome (BAC) library of onion was constructed. The average insert size of the BAC library was about 100 kb. A total of 48,000 clones, corresponding to 0.32 genome equivalent, were obtained. Fluorescent in situ hybridization (FISH) screening resulted in identification of BAC clones localized on centromeric, telomeric, or several limited interstitial chromosomal regions, although most of the clones hybridized with entire chromosomes. The partial BAC library proved to be a useful resource for molecular cytogenetic studies of onion, and should be useful for further mapping and sequencing studies of important genes of this plant. BAC FISH screening is a powerful method for identification of molecular cytogenetic markers in large-genome plants.

Identification and chromosomal location of tandemly repeated DNA sequences in Allium cepa.

A 314-bp tandemly repeated DNA sequence, named pAc074, was characterized in Allium cepa by fluorescence in situ hybridization (FISH) analyses using random amplified fragment as probe. The nucleotide sequences of the clone pAc074 is partially homologous to the satellite DNA sequences, ACSAT1, ACSAT2, and ACSAT3, of A. cepa with 81%, 81% and 78% similarity, respectively. Our sequential C-banding and FISH with pAc074 probe also clearly showed a close relation between Cheterochromatin at telomeric region and pAc074 sequences on all the chromosomes except on chromosome 6. On the long arm of chromosome 7, pAc074 sequences appeared as interstitial band which did not correspond to C-heterochromatin bands. Instead, the C-heterochromatin bands corresponded with the 5S rDNA signals. This is the first evidence of simultaneous banding of the 5S rDNA and C-band in A. cepa.

Chromosome analysis by fluorescence in situ hybridization of callus-derived regenerants in Allium cyaneum R.

Investigations were performed to confirm the optimal in vitro culture condition for callus induction and plant regeneration, to observe if somoclonal variation occurs among regenerated plants at the ploidy level and to analyse the chromosomal location of 5S and 18S-26S rRNA gene families using fluorescence in situ hybridization in callus-derived plants of Allium cyaneum. High-est callus initiation was achieved with bulb explants cultured on MS medium supplemented with 2,4-D and BAP at 1 mg l-1 each. A total of 195 plants was obtained when using MS medium supplemented with 1 mg l-1 NAA and 5 mg l-1 BAP; about 92% were diploid having 2n=16; 8% showed a variation in ploidy level. Using digoxigenin-labelled 5S rRNA and biotin-labelled 18S-26S rRNA gene probes, we compared the fluorescence in situ hybridization patterns of autotetraploid plants with the A. cyaneum wild type. The 5S rRNA gene sites were detected on the interstitial region in the short arm of chromosome 4 and on the interstitial region in both arms of chromosome 7. The 18S-26S rRNA gene sites were detected on the terminal region of the short arm, including the satellite of chromosome 5, as well as on a part of chromosome B. The chromosomal location of both rRNA genes in regenerated autotetraploid plants corresponded to those of the wild species.

Smoking as a risk indicator for periodontal disease in the middle-aged Vietnamese population.

BACKGROUND: Studies from developed countries have found smoking a significant risk indicator for periodontitis. However, few such studies have been conducted in developing populations, where the natural history of the disease is rarely confounded by treatment and smoking is highly prevalent. AIM: The present study aimed to confirm the consistency, strength and dose-response of the association of smoking with periodontitis measured by loss of attachment (LOA) in a representative middle-aged adult sample from a developing country. METHODS: A cross-sectional study with a multistage stratified random sample was conducted in two provinces of Vietnam. RESULTS: A total of 575 (response: 84.6%) 35-44-year-old subjects were interviewed and periodontally examined. Data were re-weighted to represent the population of the provinces. 28.9% were current smokers (CS), 8.6% former smokers (FS) and 62.5% never-smokers (NS). Number of cigarette pack-years was calculated to divide CS into light smokers, LS < or = 5 pack-years, and heavy smokers, HS 5+ pack-years. The US NIDR protocol was employed for LOA measurement at two sites per tooth for every tooth. HS presented with the highest prevalence of LOA exceeding various thresholds followed by LS (chi2, P < 0.001). The extent of sites with LOA > or = 4 mm and LOA > or = 6 mm was significantly higher among HS and LS compared to NS (ANOVA; P < 0.001). The severity scores of LOA for NS, FS, LS and HS were 2.42, 2.50, 2.64 and 3.05 mm respectively (ANOVA; P < 0.001). Disease cases were defined as having 2+ sites with LOA > or = 5 mm and 1+ site with PD > or = 4 mm. Compared to NS, the odds ratio for periodontitis among heavy smokers was 7.17 (CI: 2.87-17.92, P < 0.001). CONCLUSION: Smoking is a risk indicator for periodontitis among the middle-aged Vietnamese population. To pursue a population prevention approach for periodontitis, dentistry in Vietnam needs to be part of antismoking and smoking cessation programs.

Anti-atherogenic property of ferulic acid in apolipoprotein E-deficient mice fed Western diet: comparison with clofibrate.

Anti-atherogenic effect of ferulic acid (0.02%, w/w) was investigated in comparison with the clofibrate (0.02%, w/w) in apolipoprotein E-deficient (apo E(-/-)) mice fed Western diet. Concentrations of total cholesterol (total-C), apolipoprotein B (apo B) in the plasma and epididymal adipose tissue weight were significantly lower in the ferulic acid and clofibrate supplemented groups compared to the control group. The ratio of apo B to apo A-I was also significantly lower in those groups than in the control group. Activities of hepatic ACAT and HMG-CoA reductase were only significantly lower in the ferulic acid and clofibrate groups, respectively than in the control group. The numbers of mice that exhibited aortic fatty plaque were 8/10 in control groups vs. 0/10 in the ferulic acid or clofibrate group. The activities of anti-oxidant enzymes (superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and paraoxonase) in the hepatocyte and erythrocyte were significantly higher in the ferulic acid group than in the control group. In contrast, hepatic TBARS level was only markedly lower in the ferulic acid group. These results provide a new insight into the anti-atherogenic property of ferulic acid in the apo E(-/-) mice fed a Western diet.

Chromosomal localization of 5S rRNA gene loci and the implications for relationships within the Allium complex.

Chromosomal localizations and distribution patterns of the 5S rRNA genes by means of fluorescence in-situ hybridization in diploid Allium species could help to classify species into chromosome types and aid in determining relationships among genomes. All eleven diploid species were classified into five types, A to E. Species of type A showed a pair of 5S rRNA signals on the short arm of chromosome 5 and two pairs of signals on both arms of chromosome 7. Species of types B and C showed one pair and two pairs of signals on the short arm of chromosome 7, respectively. Type D species showed two pairs of signals on the satellite region of the short arm and a pair of signals on the long arm of chromosome 7. Type E species showed three distinct 5S rRNA gene loci signals on the short arm of chromosome 7. Information on chromosomal localization of 5S rRNA gene loci and distribution patterns within chromosomes in diploid Allium species could help to infer the pathway of origin of the three kinds of alloploid species. Data indicate that A. wakegi is an allopolyploid with genomes of types B and C, and A. deltoide-fistulosum is an allotetraploid derived from a natural hybridization between different species within chromosome type A. Results indicate that A. senescens is an allopolyploid with type B chromosomes and an unidentified chromosomal type.

Participation of two members of the very long-chain acyl-CoA synthetase family in bile acid synthesis and recycling.

Bile acids are synthesized de novo in the liver from cholesterol and conjugated to glycine or taurine via a complex series of reactions involving multiple organelles. Bile acids secreted into the small intestine are efficiently reabsorbed and reutilized. Activation by thioesterification to CoA is required at two points in bile acid metabolism. First, 3alpha,7alpha,12alpha-trihydroxy-5beta-cholestanoic acid, the 27-carbon precursor of cholic acid, must be activated to its CoA derivative before side chain cleavage via peroxisomal beta-oxidation. Second, reutilization of cholate and other C24 bile acids requires reactivation prior to re-conjugation. We reported previously that homolog 2 of very long-chain acyl-CoA synthetase (VLCS) can activate cholate (Steinberg, S. J., Mihalik, S. J., Kim, D. G., Cuebas, D. A., and Watkins, P. A. (2000) J. Biol. Chem. 275, 15605-15608). We now show that this enzyme also activates chenodeoxycholate, the secondary bile acids deoxycholate and lithocholate, and 3alpha,7alpha,12alpha-trihydroxy-5beta-cholestanoic acid. In contrast, VLCS activated 3alpha,7alpha,12alpha-trihydroxy-5beta-cholestanoate, but did not utilize any of the C24 bile acids as substrates. We hypothesize that the primary function of homolog 2 is in the reactivation and recycling of C24 bile acids, whereas VLCS participates in the de novo synthesis pathway. Results of in situ hybridization, topographic orientation, and inhibition studies are consistent with the proposed roles of these enzymes in bile acid metabolism.