Photodynamic chemotherapy in the treatment of superficial mycoses: an evidence-based evaluation.

Photodynamic therapy (PDT) is a constantly evolving treatment modality consisted of a chemical reaction activated by light energy that is used to selectively destroy tissue; it may be considered a particular form of photochemotherapy that uses a photosensitizer, light and oxygen. The combination of the possibility of ablation of lesion with an excellence aesthetic result has allowed the photodynamic therapy an increasing role in the treatment of skin disease, that ranges from skin cancer to cosmetic treatment. Particular attention is paid in the last years to a developing area of research, the antifungal photodynamic therapy. The growing resistance against antifungal drugs has renewed the search for alternative therapies and PDT seems to be a potential candidate. This article provides an extensive review of antifungal photodynamic therapy, its mechanisms and applications in the treatment of superficial mycoses.

In vivo evaluation of a Poly-2p barrier cream protective effect.

AIM: Theoretically, skin barrier creams reduce or even prevent the penetration into the skin by building up a physical barrier, like a thin film between the skin and the irritant. Practically, controversial experiences concerning the effectiveness of barrier creams exist. For this, we propose an in vivo method to evaluate the efficacy of barrier creams trough clinical scoring and instrumental analysis. METHODS: Nineteen housewives with hand dermatitis in remission phase were enrolled in the study. Every patient was evaluated clinically and an arbitrary score was assigned by the investigator considering erythema, exudation, lichenification and xerosis. A score was also assigned by every patient to itching and burning. As measurement of the functional state of the skin and of the effectiveness of the barrier cream, transepidermal water loss (TEWL), corneometry, colorimetry and visco-elasticity determination were performed. To investigate the protection properties against irritant products, the 24-h irritancy patch test with sodium lauryl sulphate 1% in water was used. RESULTS: Through the patch test technique the efficacy of the barrier cream was tested compared to other topical products containing corticosteroids, lipids, humectants or urea, with already known anti-inflammatory, lenitive or protective properties. The results showed this methods easy and fast in handling, non-invasive, standardized, and in vivo applicable for evaluation and ranking of barrier creams. CONCLUSION: The study preparation demonstrated high tolerability and indubitable efficacy in improving the skin barrier function even towards a very well known irritant.

Intracorporeal versus extracorporeal anastomosis after laparoscopic gastrectomy for gastric cancer. A systematic review with meta-analysis.

AIM: To perform a systematic review and meta-analyses of studies comparing the totally laparoscopic procedures with intracorporeal anastomosis (IA) to laparoscopic-assisted surgery with extracorporeal anastomosis (EA) in gastric resections. METHODS: We performed a systematic search in the electronic databases. Outcomes analysed were: intraoperative (operative time and intraoperative blood loss), oncologic (harvested nodes, distance of the tumour from proximal and distal margin), postoperative complications (gastric stasis, intraluminal and extraluminal bleeding, leakage and wound infection) recovery (time to first flatus, time to first oral intake and hospital stay). We performed meta-regression analyses after implementing a regression model with the analysed outcomes as dependent variables (y) and the demographic and pathologic covariates as independent variables (x). RESULTS: A total of 26 studies (20 on distal gastrectomy and 6 on total gastrectomy) were included in the final analysis. Regarding distal gastrectomy, there was no statistical difference between the two groups in the above-mentioned outcomes, except for intraoperative blood loss (less in IA group, P=0.003), number of harvested nodes (better in the IA group, P=0.022) and length of hospital stay (shorter in the IA group, P=0.037). Regarding total gastrectomy, there was no statistical difference for all outcomes, except for the distal margin (further in the EA group, P=0.040). Meta-regression analysis showed that a lot of variables influenced results in distal gastric resections, but not in total gastric resections. CONCLUSION: We can state laparoscopic gastric resections with IA are safe and feasible when performed by expert surgeons. However, new well-designed studies comparing the two techniques are needed to confirm the benefits of laparoscopic IA.